the case study means

The Ultimate Guide to Qualitative Research - Part 1: The Basics

• Introduction and overview
• What is qualitative research?
• What is qualitative data?
• Examples of qualitative data
• Qualitative vs. quantitative research
• Mixed methods
• Qualitative research preparation
• Theoretical perspective
• Theoretical framework
• Literature reviews

Research question

• Conceptual framework
• Conceptual vs. theoretical framework

Data collection

• Qualitative research methods
• Focus groups
• Observational research

What is a case study?

Applications for case study research, what is a good case study, process of case study design, benefits and limitations of case studies.

• Ethnographical research
• Ethical considerations
• Confidentiality and privacy
• Power dynamics
• Reflexivity

Case studies

Case studies are essential to qualitative research , offering a lens through which researchers can investigate complex phenomena within their real-life contexts. This chapter explores the concept, purpose, applications, examples, and types of case studies and provides guidance on how to conduct case study research effectively.

Whereas quantitative methods look at phenomena at scale, case study research looks at a concept or phenomenon in considerable detail. While analyzing a single case can help understand one perspective regarding the object of research inquiry, analyzing multiple cases can help obtain a more holistic sense of the topic or issue. Let's provide a basic definition of a case study, then explore its characteristics and role in the qualitative research process.

Definition of a case study

A case study in qualitative research is a strategy of inquiry that involves an in-depth investigation of a phenomenon within its real-world context. It provides researchers with the opportunity to acquire an in-depth understanding of intricate details that might not be as apparent or accessible through other methods of research. The specific case or cases being studied can be a single person, group, or organization – demarcating what constitutes a relevant case worth studying depends on the researcher and their research question .

Among qualitative research methods , a case study relies on multiple sources of evidence, such as documents, artifacts, interviews , or observations , to present a complete and nuanced understanding of the phenomenon under investigation. The objective is to illuminate the readers' understanding of the phenomenon beyond its abstract statistical or theoretical explanations.

Characteristics of case studies

Case studies typically possess a number of distinct characteristics that set them apart from other research methods. These characteristics include a focus on holistic description and explanation, flexibility in the design and data collection methods, reliance on multiple sources of evidence, and emphasis on the context in which the phenomenon occurs.

Furthermore, case studies can often involve a longitudinal examination of the case, meaning they study the case over a period of time. These characteristics allow case studies to yield comprehensive, in-depth, and richly contextualized insights about the phenomenon of interest.

The role of case studies in research

Case studies hold a unique position in the broader landscape of research methods aimed at theory development. They are instrumental when the primary research interest is to gain an intensive, detailed understanding of a phenomenon in its real-life context.

In addition, case studies can serve different purposes within research - they can be used for exploratory, descriptive, or explanatory purposes, depending on the research question and objectives. This flexibility and depth make case studies a valuable tool in the toolkit of qualitative researchers.

Remember, a well-conducted case study can offer a rich, insightful contribution to both academic and practical knowledge through theory development or theory verification, thus enhancing our understanding of complex phenomena in their real-world contexts.

What is the purpose of a case study?

Case study research aims for a more comprehensive understanding of phenomena, requiring various research methods to gather information for qualitative analysis . Ultimately, a case study can allow the researcher to gain insight into a particular object of inquiry and develop a theoretical framework relevant to the research inquiry.

Why use case studies in qualitative research?

Using case studies as a research strategy depends mainly on the nature of the research question and the researcher's access to the data.

Conducting case study research provides a level of detail and contextual richness that other research methods might not offer. They are beneficial when there's a need to understand complex social phenomena within their natural contexts.

The explanatory, exploratory, and descriptive roles of case studies

Case studies can take on various roles depending on the research objectives. They can be exploratory when the research aims to discover new phenomena or define new research questions; they are descriptive when the objective is to depict a phenomenon within its context in a detailed manner; and they can be explanatory if the goal is to understand specific relationships within the studied context. Thus, the versatility of case studies allows researchers to approach their topic from different angles, offering multiple ways to uncover and interpret the data .

The impact of case studies on knowledge development

Case studies play a significant role in knowledge development across various disciplines. Analysis of cases provides an avenue for researchers to explore phenomena within their context based on the collected data.

This can result in the production of rich, practical insights that can be instrumental in both theory-building and practice. Case studies allow researchers to delve into the intricacies and complexities of real-life situations, uncovering insights that might otherwise remain hidden.

Types of case studies

In qualitative research , a case study is not a one-size-fits-all approach. Depending on the nature of the research question and the specific objectives of the study, researchers might choose to use different types of case studies. These types differ in their focus, methodology, and the level of detail they provide about the phenomenon under investigation.

Understanding these types is crucial for selecting the most appropriate approach for your research project and effectively achieving your research goals. Let's briefly look at the main types of case studies.

Exploratory case studies

Exploratory case studies are typically conducted to develop a theory or framework around an understudied phenomenon. They can also serve as a precursor to a larger-scale research project. Exploratory case studies are useful when a researcher wants to identify the key issues or questions which can spur more extensive study or be used to develop propositions for further research. These case studies are characterized by flexibility, allowing researchers to explore various aspects of a phenomenon as they emerge, which can also form the foundation for subsequent studies.

Descriptive case studies

Descriptive case studies aim to provide a complete and accurate representation of a phenomenon or event within its context. These case studies are often based on an established theoretical framework, which guides how data is collected and analyzed. The researcher is concerned with describing the phenomenon in detail, as it occurs naturally, without trying to influence or manipulate it.

Explanatory case studies

Explanatory case studies are focused on explanation - they seek to clarify how or why certain phenomena occur. Often used in complex, real-life situations, they can be particularly valuable in clarifying causal relationships among concepts and understanding the interplay between different factors within a specific context.

Intrinsic, instrumental, and collective case studies

These three categories of case studies focus on the nature and purpose of the study. An intrinsic case study is conducted when a researcher has an inherent interest in the case itself. Instrumental case studies are employed when the case is used to provide insight into a particular issue or phenomenon. A collective case study, on the other hand, involves studying multiple cases simultaneously to investigate some general phenomena.

Each type of case study serves a different purpose and has its own strengths and challenges. The selection of the type should be guided by the research question and objectives, as well as the context and constraints of the research.

The flexibility, depth, and contextual richness offered by case studies make this approach an excellent research method for various fields of study. They enable researchers to investigate real-world phenomena within their specific contexts, capturing nuances that other research methods might miss. Across numerous fields, case studies provide valuable insights into complex issues.

Critical information systems research

Case studies provide a detailed understanding of the role and impact of information systems in different contexts. They offer a platform to explore how information systems are designed, implemented, and used and how they interact with various social, economic, and political factors. Case studies in this field often focus on examining the intricate relationship between technology, organizational processes, and user behavior, helping to uncover insights that can inform better system design and implementation.

Health research

Health research is another field where case studies are highly valuable. They offer a way to explore patient experiences, healthcare delivery processes, and the impact of various interventions in a real-world context.

Case studies can provide a deep understanding of a patient's journey, giving insights into the intricacies of disease progression, treatment effects, and the psychosocial aspects of health and illness.

Asthma research studies

Specifically within medical research, studies on asthma often employ case studies to explore the individual and environmental factors that influence asthma development, management, and outcomes. A case study can provide rich, detailed data about individual patients' experiences, from the triggers and symptoms they experience to the effectiveness of various management strategies. This can be crucial for developing patient-centered asthma care approaches.

Other fields

Apart from the fields mentioned, case studies are also extensively used in business and management research, education research, and political sciences, among many others. They provide an opportunity to delve into the intricacies of real-world situations, allowing for a comprehensive understanding of various phenomena.

Case studies, with their depth and contextual focus, offer unique insights across these varied fields. They allow researchers to illuminate the complexities of real-life situations, contributing to both theory and practice.

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Understanding the key elements of case study design is crucial for conducting rigorous and impactful case study research. A well-structured design guides the researcher through the process, ensuring that the study is methodologically sound and its findings are reliable and valid. The main elements of case study design include the research question , propositions, units of analysis, and the logic linking the data to the propositions.

The research question is the foundation of any research study. A good research question guides the direction of the study and informs the selection of the case, the methods of collecting data, and the analysis techniques. A well-formulated research question in case study research is typically clear, focused, and complex enough to merit further detailed examination of the relevant case(s).

Propositions

Propositions, though not necessary in every case study, provide a direction by stating what we might expect to find in the data collected. They guide how data is collected and analyzed by helping researchers focus on specific aspects of the case. They are particularly important in explanatory case studies, which seek to understand the relationships among concepts within the studied phenomenon.

Units of analysis

The unit of analysis refers to the case, or the main entity or entities that are being analyzed in the study. In case study research, the unit of analysis can be an individual, a group, an organization, a decision, an event, or even a time period. It's crucial to clearly define the unit of analysis, as it shapes the qualitative data analysis process by allowing the researcher to analyze a particular case and synthesize analysis across multiple case studies to draw conclusions.

Argumentation

This refers to the inferential model that allows researchers to draw conclusions from the data. The researcher needs to ensure that there is a clear link between the data, the propositions (if any), and the conclusions drawn. This argumentation is what enables the researcher to make valid and credible inferences about the phenomenon under study.

Understanding and carefully considering these elements in the design phase of a case study can significantly enhance the quality of the research. It can help ensure that the study is methodologically sound and its findings contribute meaningful insights about the case.

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Conducting a case study involves several steps, from defining the research question and selecting the case to collecting and analyzing data . This section outlines these key stages, providing a practical guide on how to conduct case study research.

Defining the research question

The first step in case study research is defining a clear, focused research question. This question should guide the entire research process, from case selection to analysis. It's crucial to ensure that the research question is suitable for a case study approach. Typically, such questions are exploratory or descriptive in nature and focus on understanding a phenomenon within its real-life context.

Selecting and defining the case

The selection of the case should be based on the research question and the objectives of the study. It involves choosing a unique example or a set of examples that provide rich, in-depth data about the phenomenon under investigation. After selecting the case, it's crucial to define it clearly, setting the boundaries of the case, including the time period and the specific context.

Previous research can help guide the case study design. When considering a case study, an example of a case could be taken from previous case study research and used to define cases in a new research inquiry. Considering recently published examples can help understand how to select and define cases effectively.

Developing a detailed case study protocol

A case study protocol outlines the procedures and general rules to be followed during the case study. This includes the data collection methods to be used, the sources of data, and the procedures for analysis. Having a detailed case study protocol ensures consistency and reliability in the study.

The protocol should also consider how to work with the people involved in the research context to grant the research team access to collecting data. As mentioned in previous sections of this guide, establishing rapport is an essential component of qualitative research as it shapes the overall potential for collecting and analyzing data.

Collecting data

Gathering data in case study research often involves multiple sources of evidence, including documents, archival records, interviews, observations, and physical artifacts. This allows for a comprehensive understanding of the case. The process for gathering data should be systematic and carefully documented to ensure the reliability and validity of the study.

Analyzing and interpreting data

The next step is analyzing the data. This involves organizing the data , categorizing it into themes or patterns , and interpreting these patterns to answer the research question. The analysis might also involve comparing the findings with prior research or theoretical propositions.

Writing the case study report

The final step is writing the case study report . This should provide a detailed description of the case, the data, the analysis process, and the findings. The report should be clear, organized, and carefully written to ensure that the reader can understand the case and the conclusions drawn from it.

Each of these steps is crucial in ensuring that the case study research is rigorous, reliable, and provides valuable insights about the case.

The type, depth, and quality of data in your study can significantly influence the validity and utility of the study. In case study research, data is usually collected from multiple sources to provide a comprehensive and nuanced understanding of the case. This section will outline the various methods of collecting data used in case study research and discuss considerations for ensuring the quality of the data.

Interviews are a common method of gathering data in case study research. They can provide rich, in-depth data about the perspectives, experiences, and interpretations of the individuals involved in the case. Interviews can be structured , semi-structured , or unstructured , depending on the research question and the degree of flexibility needed.

Observations

Observations involve the researcher observing the case in its natural setting, providing first-hand information about the case and its context. Observations can provide data that might not be revealed in interviews or documents, such as non-verbal cues or contextual information.

Documents and artifacts

Documents and archival records provide a valuable source of data in case study research. They can include reports, letters, memos, meeting minutes, email correspondence, and various public and private documents related to the case.

These records can provide historical context, corroborate evidence from other sources, and offer insights into the case that might not be apparent from interviews or observations.

Physical artifacts refer to any physical evidence related to the case, such as tools, products, or physical environments. These artifacts can provide tangible insights into the case, complementing the data gathered from other sources.

Ensuring the quality of data collection

Determining the quality of data in case study research requires careful planning and execution. It's crucial to ensure that the data is reliable, accurate, and relevant to the research question. This involves selecting appropriate methods of collecting data, properly training interviewers or observers, and systematically recording and storing the data. It also includes considering ethical issues related to collecting and handling data, such as obtaining informed consent and ensuring the privacy and confidentiality of the participants.

Data analysis

Analyzing case study research involves making sense of the rich, detailed data to answer the research question. This process can be challenging due to the volume and complexity of case study data. However, a systematic and rigorous approach to analysis can ensure that the findings are credible and meaningful. This section outlines the main steps and considerations in analyzing data in case study research.

Organizing the data

The first step in the analysis is organizing the data. This involves sorting the data into manageable sections, often according to the data source or the theme. This step can also involve transcribing interviews, digitizing physical artifacts, or organizing observational data.

Categorizing and coding the data

Once the data is organized, the next step is to categorize or code the data. This involves identifying common themes, patterns, or concepts in the data and assigning codes to relevant data segments. Coding can be done manually or with the help of software tools, and in either case, qualitative analysis software can greatly facilitate the entire coding process. Coding helps to reduce the data to a set of themes or categories that can be more easily analyzed.

Identifying patterns and themes

After coding the data, the researcher looks for patterns or themes in the coded data. This involves comparing and contrasting the codes and looking for relationships or patterns among them. The identified patterns and themes should help answer the research question.

Interpreting the data

Once patterns and themes have been identified, the next step is to interpret these findings. This involves explaining what the patterns or themes mean in the context of the research question and the case. This interpretation should be grounded in the data, but it can also involve drawing on theoretical concepts or prior research.

Verification of the data

The last step in the analysis is verification. This involves checking the accuracy and consistency of the analysis process and confirming that the findings are supported by the data. This can involve re-checking the original data, checking the consistency of codes, or seeking feedback from research participants or peers.

Like any research method , case study research has its strengths and limitations. Researchers must be aware of these, as they can influence the design, conduct, and interpretation of the study.

Understanding the strengths and limitations of case study research can also guide researchers in deciding whether this approach is suitable for their research question . This section outlines some of the key strengths and limitations of case study research.

Benefits include the following:

• Rich, detailed data: One of the main strengths of case study research is that it can generate rich, detailed data about the case. This can provide a deep understanding of the case and its context, which can be valuable in exploring complex phenomena.
• Flexibility: Case study research is flexible in terms of design , data collection , and analysis . A sufficient degree of flexibility allows the researcher to adapt the study according to the case and the emerging findings.
• Real-world context: Case study research involves studying the case in its real-world context, which can provide valuable insights into the interplay between the case and its context.
• Multiple sources of evidence: Case study research often involves collecting data from multiple sources , which can enhance the robustness and validity of the findings.

On the other hand, researchers should consider the following limitations:

• Generalizability: A common criticism of case study research is that its findings might not be generalizable to other cases due to the specificity and uniqueness of each case.
• Time and resource intensive: Case study research can be time and resource intensive due to the depth of the investigation and the amount of collected data.
• Complexity of analysis: The rich, detailed data generated in case study research can make analyzing the data challenging.
• Subjectivity: Given the nature of case study research, there may be a higher degree of subjectivity in interpreting the data , so researchers need to reflect on this and transparently convey to audiences how the research was conducted.

Being aware of these strengths and limitations can help researchers design and conduct case study research effectively and interpret and report the findings appropriately.

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• Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

Published on 5 May 2022 by Shona McCombes . Revised on 30 January 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organisation, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating, and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyse the case.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

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Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

Unlike quantitative or experimental research, a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

If you find yourself aiming to simultaneously investigate and solve an issue, consider conducting action research . As its name suggests, action research conducts research and takes action at the same time, and is highly iterative and flexible. 

However, you can also choose a more common or representative case to exemplify a particular category, experience, or phenomenon.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews, observations, and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data .

The aim is to gain as thorough an understanding as possible of the case and its context.

In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis, with separate sections or chapters for the methods , results , and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyse its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

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Meaning of case study in English

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Definition of case study

Examples of case study in a sentence.

These examples are programmatically compiled from various online sources to illustrate current usage of the word 'case study.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

Word History

1914, in the meaning defined at sense 1

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“Case study.” Merriam-Webster.com Dictionary , Merriam-Webster, https://www.merriam-webster.com/dictionary/case%20study. Accessed 9 May. 2024.

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Writing a Case Study

What is a case study?

A Case study is: 

• An in-depth research design that primarily uses a qualitative methodology but sometimes​​ includes quantitative methodology.
• Used to examine an identifiable problem confirmed through research.
• Used to investigate an individual, group of people, organization, or event.
• Used to mostly answer "how" and "why" questions.

What are the different types of case studies?

Note: These are the primary case studies. As you continue to research and learn

about case studies you will begin to find a robust list of different types. 

Who are your case study participants?

What is triangulation ? 

Validity and credibility are an essential part of the case study. Therefore, the researcher should include triangulation to ensure trustworthiness while accurately reflecting what the researcher seeks to investigate.

How to write a Case Study?

When developing a case study, there are different ways you could present the information, but remember to include the five parts for your case study.

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Home » Case Study – Methods, Examples and Guide

Case Study – Methods, Examples and Guide

Table of Contents

A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.

It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.

For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.

Multiple-Case Study

A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.

For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.

Exploratory Case Study

An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.

For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.

Descriptive Case Study

A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.

For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.

Instrumental Case Study

An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.

For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.

Observations

Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.

Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.

Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.

Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.

How to conduct Case Study Research

Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:

• Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
• Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
• Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
• Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
• Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
• Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
• Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.

Examples of Case Study

Here are some examples of case study research:

• The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
• The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
• The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
• The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
• The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.

Application of Case Study

Case studies have a wide range of applications across various fields and industries. Here are some examples:

Business and Management

Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.

Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.

Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.

Social Sciences

Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.

Law and Ethics

Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.

Purpose of Case Study

The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.

The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.

Case studies can also serve other purposes, including:

• Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
• Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
• Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
• Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.

Advantages of Case Study Research

There are several advantages of case study research, including:

• In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
• Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
• Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
• Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
• Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
• Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.

Limitations of Case Study Research

There are several limitations of case study research, including:

• Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
• Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
• Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
• Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
• Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
• Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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A case study research paper examines a person, place, event, condition, phenomenon, or other type of subject of analysis in order to extrapolate  key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study research paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or more subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.

Case Studies. Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.

How to Approach Writing a Case Study Research Paper

General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in the Organizing Your Social Sciences Research Paper writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a case study design.

However, identifying a case to investigate involves more than choosing the research problem . A case study encompasses a problem contextualized around the application of in-depth analysis, interpretation, and discussion, often resulting in specific recommendations for action or for improving existing conditions. As Seawright and Gerring note, practical considerations such as time and access to information can influence case selection, but these issues should not be the sole factors used in describing the methodological justification for identifying a particular case to study. Given this, selecting a case includes considering the following:

• The case represents an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
• The case provides important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
• The case challenges and offers a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in current practice. A case study analysis may offer an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
• The case provides an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings so as to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
• The case offers a new direction in future research? A case study can be used as a tool for an exploratory investigation that highlights the need for further research about the problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of east central Africa. A case study of how women contribute to saving water in a rural village of Uganda can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community. This example of a case study could also point to the need for scholars to build new theoretical frameworks around the topic [e.g., applying feminist theories of work and family to the issue of water conservation].

Eisenhardt, Kathleen M. “Building Theories from Case Study Research.” Academy of Management Review 14 (October 1989): 532-550; Emmel, Nick. Sampling and Choosing Cases in Qualitative Research: A Realist Approach . Thousand Oaks, CA: SAGE Publications, 2013; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Seawright, Jason and John Gerring. "Case Selection Techniques in Case Study Research." Political Research Quarterly 61 (June 2008): 294-308.

Structure and Writing Style

The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work.

In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I.  Introduction

As with any research paper, your introduction should serve as a roadmap for your readers to ascertain the scope and purpose of your study . The introduction to a case study research paper, however, should not only describe the research problem and its significance, but you should also succinctly describe why the case is being used and how it relates to addressing the problem. The two elements should be linked. With this in mind, a good introduction answers these four questions:

• What is being studied? Describe the research problem and describe the subject of analysis [the case] you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
• Why is this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
• What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
• How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.

Each of these questions should be addressed in no more than a few paragraphs. Exceptions to this can be when you are addressing a complex research problem or subject of analysis that requires more in-depth background information.

II.  Literature Review

The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and  enabling historical interpretation of the subject of analysis in relation to the research problem the case is intended to address . This includes synthesizing studies that help to:

• Place relevant works in the context of their contribution to understanding the case study being investigated . This would involve summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
• Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to investigate the research problem and the underlying research questions.
• Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your use of a case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
• Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
• Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
• Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
• Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in relation to explaining the relevance of the case in addressing the research problem.

III.  Method

In this section, you explain why you selected a particular case [i.e., subject of analysis] and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that constitutes your case study.

If your subject of analysis is an incident or event . In the social and behavioral sciences, the event or incident that represents the case to be studied is usually bounded by time and place, with a clear beginning and end and with an identifiable location or position relative to its surroundings. The subject of analysis can be a rare or critical event or it can focus on a typical or regular event. The purpose of studying a rare event is to illuminate new ways of thinking about the broader research problem or to test a hypothesis. Critical incident case studies must describe the method by which you identified the event and explain the process by which you determined the validity of this case to inform broader perspectives about the research problem or to reveal new findings. However, the event does not have to be a rare or uniquely significant to support new thinking about the research problem or to challenge an existing hypothesis. For example, Walo, Bull, and Breen conducted a case study to identify and evaluate the direct and indirect economic benefits and costs of a local sports event in the City of Lismore, New South Wales, Australia. The purpose of their study was to provide new insights from measuring the impact of a typical local sports event that prior studies could not measure well because they focused on large "mega-events." Whether the event is rare or not, the methods section should include an explanation of the following characteristics of the event: a) when did it take place; b) what were the underlying circumstances leading to the event; and, c) what were the consequences of the event in relation to the research problem.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experiences they have had that provide an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of their experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using them as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem [e.g., why is one politician in a particular local election used to show an increase in voter turnout from any other candidate running in the election]. Note that these issues apply to a specific group of people used as a case study unit of analysis [e.g., a classroom of students].

If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, historical, cultural, economic, political], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, explain why you are studying Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research suggests Echo Park has more homeless veterans].

If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut off? How might knowing the suppliers of these trucks reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.

NOTE:   The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should clearly support investigation of the research problem and linked to key findings from your literature review. Be sure to cite any studies that helped you determine that the case you chose was appropriate for examining the problem.

IV.  Discussion

The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your analysis of the case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is common to combine a description of the results with the discussion about their implications. The objectives of your discussion section should include the following:

Reiterate the Research Problem/State the Major Findings Briefly reiterate the research problem you are investigating and explain why the subject of analysis around which you designed the case study were used. You should then describe the findings revealed from your study of the case using direct, declarative, and succinct proclamation of the study results. Highlight any findings that were unexpected or especially profound.

Explain the Meaning of the Findings and Why They are Important Systematically explain the meaning of your case study findings and why you believe they are important. Begin this part of the section by repeating what you consider to be your most important or surprising finding first, then systematically review each finding. Be sure to thoroughly extrapolate what your analysis of the case can tell the reader about situations or conditions beyond the actual case that was studied while, at the same time, being careful not to misconstrue or conflate a finding that undermines the external validity of your conclusions.

Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.

Consider Alternative Explanations of the Findings Remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations revealed by the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research if that is how the findings can be interpreted from your case.

Acknowledge the Study's Limitations You can state the study's limitations in the conclusion section of your paper but describing the limitations of your subject of analysis in the discussion section provides an opportunity to identify the limitations and explain why they are not significant. This part of the discussion section should also note any unanswered questions or issues your case study could not address. More detailed information about how to document any limitations to your research can be found here .

Suggest Areas for Further Research Although your case study may offer important insights about the research problem, there are likely additional questions related to the problem that remain unanswered or findings that unexpectedly revealed themselves as a result of your in-depth analysis of the case. Be sure that the recommendations for further research are linked to the research problem and that you explain why your recommendations are valid in other contexts and based on the original assumptions of your study.

V.  Conclusion

As with any research paper, you should summarize your conclusion in clear, simple language; emphasize how the findings from your case study differs from or supports prior research and why. Do not simply reiterate the discussion section. Provide a synthesis of key findings presented in the paper to show how these converge to address the research problem. If you haven't already done so in the discussion section, be sure to document the limitations of your case study and any need for further research.

The function of your paper's conclusion is to: 1) reiterate the main argument supported by the findings from your case study; 2) state clearly the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.

Consider the following points to help ensure your conclusion is appropriate:

• If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
• If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
• Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.

Note that, depending on the discipline you are writing in or the preferences of your professor, the concluding paragraph may contain your final reflections on the evidence presented as it applies to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.

Problems to Avoid

Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were engaged with social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.

Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood more in terms of managing access rather than preserving access to a scarce resource.

Failure to Extrapolate All Possible Implications Just as you don't want to over-generalize from your case study findings, you also have to be thorough in the consideration of all possible outcomes or recommendations derived from your findings. If you do not, your reader may question the validity of your analysis, particularly if you failed to document an obvious outcome from your case study research. For example, in the case of studying the accident at the railroad crossing to evaluate where and what types of warning signals should be located, you failed to take into consideration speed limit signage as well as warning signals. When designing your case study, be sure you have thoroughly addressed all aspects of the problem and do not leave gaps in your analysis that leave the reader questioning the results.

Case Studies. Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009;  Kratochwill,  Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education .  Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.

Writing Tip

At Least Five Misconceptions about Case Study Research

Social science case studies are often perceived as limited in their ability to create new knowledge because they are not randomly selected and findings cannot be generalized to larger populations. Flyvbjerg examines five misunderstandings about case study research and systematically "corrects" each one. To quote, these are:

Misunderstanding 1 :  General, theoretical [context-independent] knowledge is more valuable than concrete, practical [context-dependent] knowledge. Misunderstanding 2 :  One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 :  The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 :  The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 :  It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].

While writing your paper, think introspectively about how you addressed these misconceptions because to do so can help you strengthen the validity and reliability of your research by clarifying issues of case selection, the testing and challenging of existing assumptions, the interpretation of key findings, and the summation of case outcomes. Think of a case study research paper as a complete, in-depth narrative about the specific properties and key characteristics of your subject of analysis applied to the research problem.

Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.

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What Is a Case Study?

Weighing the pros and cons of this method of research

Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

Cara Lustik is a fact-checker and copywriter.

Verywell / Colleen Tighe

• Pros and Cons

What Types of Case Studies Are Out There?

Where do you find data for a case study, how do i write a psychology case study.

A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.

The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.

While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.  

At a Glance

A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.

What Are the Benefits and Limitations of Case Studies?

A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.

One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:

• Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
• Gives researchers the chance to collect information on why one strategy might be chosen over another
• Permits researchers to develop hypotheses that can be explored in experimental research

On the other hand, a case study can have some drawbacks:

• It cannot necessarily be generalized to the larger population
• Cannot demonstrate cause and effect
• It may not be scientifically rigorous
• It can lead to bias

Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.

It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.

Case Study Examples

There have been a number of notable case studies in the history of psychology. Much of  Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:

• Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
• Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
• Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.

Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.

This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.

There are a few different types of case studies that psychologists and other researchers might use:

• Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
• Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
• Explanatory case studies : These   are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
• Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
• Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
• Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.

The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.

The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.

There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:

• Archival records : Census records, survey records, and name lists are examples of archival records.
• Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
• Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
• Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
• Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
• Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.

If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.

Here is a general outline of what should be included in a case study.

Section 1: A Case History

This section will have the following structure and content:

Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.

Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.

Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.

Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.

Section 2: Treatment Plan

This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.

• Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
• Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
• Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
• Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.

This section of a case study should also include information about the treatment goals, process, and outcomes.

When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research. 

In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?

Need More Tips?

Here are a few additional pointers to keep in mind when formatting your case study:

• Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
• Read examples of case studies to gain an idea about the style and format.
• Remember to use APA format when citing references .

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach .  BMC Med Res Methodol . 2011;11:100.

Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100

Gagnon, Yves-Chantal.  The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.

Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.

By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."

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What Is a Case Study and Why You Should Use Them

Case studies can provide more insights into your business while helping you conduct further research with robust qualitative data analysis to learn more.

If you're in charge of running a company, then you're likely always looking for new ways to run your business more efficiently and increase your customer base while streamlining as many processes as possible.

Unfortunately, it can sometimes be difficult to determine how to go about implementing the proper program in order to be successful. This is why many business owners opt to conduct a case study, which can help significantly. Whether you've been struggling with brand consistency or some other problem, the right case study can identify why your problem exists as well as provide a way to rectify it.

A case study is a great tool that many businesses aren't even aware exists, and there are marketing experts like Mailchimp who can provide you with step-by-step assistance with implementing a plan with a case study. Many companies discover that not only do they need to start a blog in order to improve business, but they also need to create specific and relevant blog titles.

If your company already has a blog, then optimizing your blog posts may be helpful. Regardless of the obstacles that are preventing you from achieving all your professional goals, a case study can work wonders in helping you reverse this issue.

What is a case study?

A case study is a comprehensive report of the results of theory testing or examining emerging themes of a business in real life context. Case studies are also often used in the healthcare industry, conducting health services research with primary research interest around routinely collected healthcare data.

However, for businesses, the purpose of a case study is to help small business owners or company leaders identify the issues and conduct further research into what may be preventing success through information collection, client or customer interviews, and in-depth data analysis.

Knowing the case study definition is crucial for any business owner. By identifying the issues that are hindering a company from achieving all its goals, it's easier to make the necessary corrections to promote success through influenced data collection.

Why are case studies important?

Now that we've answered the questions, "what is a case study?" Why are case studies important? Some of the top reasons why case studies are important include:

• Understand complex issues: Even after you conduct a significant amount of market research , you might have a difficult time understanding exactly what it means. While you might have the basics down, conducting a case study can help you see how that information is applied. Then, when you see how the information can make a difference in business decisions, it could make it easier to understand complex issues.
• Collect data: A case study can also help with data tracking . A case study is a data collection method that can help you describe the information that you have available to you. Then, you can present that information in a way the reader can understand.
• Conduct evaluations: As you learn more about how to write a case study, remember that you can also use a case study to conduct evaluations of a specific situation. A case study is a great way to learn more about complex situations, and you can evaluate how various people responded in that situation. By conducting a case study evaluation, you can learn more about what has worked well, what has not, and what you might want to change in the future.
• Identify potential solutions: A case study can also help you identify solutions to potential problems. If you have an issue in your business that you are trying to solve, you may be able to take a look at a case study where someone has dealt with a similar situation in the past. For example, you may uncover data bias in a specific solution that you would like to address when you tackle the issue on your own. If you need help solving a difficult problem, a case study may be able to help you.

Remember that you can also use case studies to target your audience . If you want to show your audience that you have a significant level of expertise in a field, you may want to publish some case studies that you have handled in the past. Then, when your audience sees that you have had success in a specific area, they may be more likely to provide you with their business. In essence, case studies can be looked at as the original method of social proof, showcasing exactly how you can help someone solve their problems.

What are the benefits of writing a business case study?

Although writing a case study can seem like a tedious task, there are many benefits to conducting one through an in depth qualitative research process.

• Industry understanding: First of all, a case study can give you an in-depth understanding of your industry through a particular conceptual framework and help you identify hidden problems that are preventing you from transcending into the business world.
• Develop theories: If you decide to write a business case study, it provides you with an opportunity to develop new theories. You might have a theory about how to solve a specific problem, but you need to write a business case study to see exactly how that theory has unfolded in the past. Then, you can figure out if you want to apply your theory to a similar issue in the future.
• Evaluate interventions: When you write a business case study that focuses on a specific situation you have been through in the past, you can uncover whether that intervention was truly helpful. This can make it easier to figure out whether you want to use the same intervention in a similar situation in the future.
• Identify best practices: If you want to stay on top of the best practices in your field, conducting case studies can help by allowing you to identify patterns and trends and develop a new list of best practices that you can follow in the future.
• Versatility: Writing a case study also provides you with more versatility. If you want to expand your business applications, you need to figure out how you respond to various problems. When you run a business case study, you open the door to new opportunities, new applications, and new techniques that could help you make a difference in your business down the road.
• Solve problems: Writing a great case study can dramatically improve your chances of reversing your problem and improving your business.
• These are just a few of the biggest benefits you might experience if you decide to publish your case studies. They can be an effective tool for learning, showcasing your talents, and teaching some of your other employees. If you want to grow your audience , you may want to consider publishing some case studies.

What are the limitations of case studies?

Case studies can be a wonderful tool for any business of any size to use to gain an in-depth understanding of their clients, products, customers, or services, but there are limitations.

One limitation of case studies is the fact that, unless there are other recently published examples, there is nothing to compare them to since, most of the time, you are conducting a single, not multiple, case studies.

Another limitation is the fact that most case studies can lack scientific evidence.

Types of case studies

There are specific types of case studies to choose from, and each specific type will yield different results. Some case study types even overlap, which is sometimes more favorable, as they provide even more pertinent data.

Here are overviews of the different types of case studies, each with its own theoretical framework, so you can determine which type would be most effective for helping you meet your goals.

Explanatory case studies

Explanatory case studies are pretty straightforward, as they're not difficult to interpret. This type of case study is best if there aren't many variables involved because explanatory case studies can easily answer questions like "how" and "why" through theory development.

Exploratory case studies

An exploratory case study does exactly what its name implies: it goes into specific detail about the topic at hand in a natural, real-life context with qualitative research.

The benefits of exploratory case studies are limitless, with the main one being that it offers a great deal of flexibility. Having flexibility when writing a case study is important because you can't always predict what obstacles might arise during the qualitative research process.

Collective case studies

Collective case studies require you to study many different individuals in order to obtain usable data.

Case studies that involve an investigation of people will involve many different variables, all of which can't be predicted. Despite this fact, there are many benefits of collective case studies, including the fact that it allows an ongoing analysis of the data collected.

Intrinsic case studies

This type of study differs from the others as it focuses on the inquiry of one specific instance among many possibilities.

Many people prefer these types of case studies because it allows them to learn about the particular instance that they wish to investigate further.

Instrumental case studies

An instrumental case study is similar to an intrinsic one, as it focuses on a particular instance, whether it's a person, organization, or something different.

One thing that differentiates instrumental case studies from intrinsic ones is the fact that instrumental case studies aren't chosen merely because a person is interested in learning about a specific instance.

Tips for writing a case study

If you have decided to write case studies for your company, then you may be unsure of where to start or which type to conduct.

However, it doesn't have to be difficult or confusing to begin conducting a case study that will help you identify ways to improve your business.

Here are some helpful tips for writing your case studies:

1. Your case study must be written in the proper format

When writing a case study, the format that you should be similar to this:

Administrative summary

The executive summary is an overview of what your report will contain, written in a concise manner while providing real-life context.

Despite the fact that the executive summary should appear at the beginning of your case studies, it shouldn't be written until you've completed the entire report because if you write it before you finish the report, this summary may not be completely accurate.

Key problem statement

In this section of your case study, you will briefly describe the problem that you hope to solve by conducting the study. You will have the opportunity to elaborate on the problem that you're focusing on as you get into the breadth of the report.

Problem exploration

This part of the case study isn't as brief as the other two, and it goes into more detail about the problem at hand. Your problem exploration must include why the identified problem needs to be solved as well as the urgency of solving it.

Additionally, it must include justification for conducting the problem-solving, as the benefits must outweigh the efforts and costs.

Proposed resolution

This case study section will also be lengthier than the first two. It must include how you propose going about rectifying the problem. The "recommended solution" section must also include potential obstacles that you might experience, as well as how these will be managed.

Furthermore, you will need to list alternative solutions and explain the reason the chosen solution is best. Charts can enhance your report and make it easier to read, and provide as much proof to substantiate your claim as possible.

Overview of monetary consideration

An overview of monetary consideration is essential for all case studies, as it will be used to convince all involved parties why your project should be funded. You must successfully convince them that the cost is worth the investment it will require. It's important that you stress the necessity for this particular case study and explain the expected outcome.

Execution timeline

In the execution times of case studies, you explain how long you predict it will take to implement your study. The shorter the time it will take to implement your plan, the more apt it is to be approved. However, be sure to provide a reasonable timeline, taking into consideration any additional time that might be needed due to obstacles.

Always include a conclusion in your case study. This is where you will briefly wrap up your entire proposal, stressing the benefits of completing the data collection and data analysis in order to rectify your problem.

2. Make it clear and comprehensive

You want to write your case studies with as much clarity as possible so that every aspect of the report is understood. Be sure to double-check your grammar, spelling, punctuation, and more, as you don't want to submit a poorly-written document.

Not only would a poorly-written case study fail to prove that what you are trying to achieve is important, but it would also increase the chances that your report will be tossed aside and not taken seriously.

3. Don't rush through the process

Writing the perfect case study takes time and patience. Rushing could result in your forgetting to include information that is crucial to your entire study. Don't waste your time creating a study that simply isn't ready. Take the necessary time to perform all the research necessary to write the best case study possible.

Depending on the case study, conducting case study research could mean using qualitative methods, quantitative methods, or both. Qualitative research questions focus on non-numerical data, such as how people feel, their beliefs, their experiences, and so on.

Meanwhile, quantitative research questions focus on numerical or statistical data collection to explain causal links or get an in-depth picture.

It is also important to collect insightful and constructive feedback. This will help you better understand the outcome as well as any changes you need to make to future case studies. Consider using formal and informal ways to collect feedback to ensure that you get a range of opinions and perspectives.

4. Be confident in your theory development

While writing your case study or conducting your formal experimental investigation, you should have confidence in yourself and what you're proposing in your report. If you took the time to gather all the pertinent data collected to complete the report, don't second-guess yourself or doubt your abilities. If you believe your report will be amazing, then it likely will be.

5. Case studies and all qualitative research are long

It's expected that multiple case studies are going to be incredibly boring, and there is no way around this. However, it doesn't mean you can choose your language carefully in order to keep your audience as engaged as possible.

If your audience loses interest in your case study at the beginning, for whatever reason, then this increases the likelihood that your case study will not be funded.

Case study examples

If you want to learn more about how to write a case study, it might be beneficial to take a look at a few case study examples. Below are a few interesting case study examples you may want to take a closer look at.

• Phineas Gage by John Martin Marlow : One of the most famous case studies comes from the medical field, and it is about the story of Phineas Gage, a man who had a railroad spike driven through his head in 1848. As he was working on a railroad, an explosive charge went off prematurely, sending a railroad rod through his head. Even though he survived this incident, he lost his left eye. However, Phineas Gage was studied extensively over the years because his experiences had a significant, lasting impact on his personality. This served as a case study because his injury showed different parts of the brain have different functions.
• Kitty Genovese and the bystander effect : This is a tragic case study that discusses the murder of Kitty Genovese, a woman attacked and murdered in Queens, New York City. Shockingly, while numerous neighbors watched the scene, nobody called for help because they assumed someone else would. This case study helped to define the bystander effect, which is when a person fails to intervene during an emergency because other people are around.
• Henry Molaison and the study of memory : Henry Molaison lost his memory and suffered from debilitating amnesia. He suffered from childhood epilepsy, and medical professionals attempted to remove the part of his brain that was causing his seizures. He had a portion of his brain removed, but it completely took away his ability to hold memories. Even though he went on to live until the age of 82, he was always forced to live in the present moment, as he was completely unable to form new memories.

Case study FAQs

When should you do a case study.

There are several scenarios when conducting a case study can be beneficial. Case studies are often used when there's a "why" or "how" question that needs to be answered. Case studies are also beneficial when trying to understand a complex phenomenon, there's limited research on a topic, or when you're looking for practical solutions to a problem.

How can case study results be used to make business decisions?

You can use the results from a case study to make future business decisions if you find yourself in a similar situation. As you assess the results of a case study, you can identify best practices, evaluate the effectiveness of an intervention, generate new and creative ideas, or get a better understanding of customer needs.

How are case studies different from other research methodologies?

When compared to other research methodologies, such as experimental or qualitative research methodology, a case study does not require a representative sample. For example, if you are performing quantitative research, you have a lot of subjects that expand your sample size. If you are performing experimental research, you may have a random sample in front of you. A case study is usually designed to deliberately focus on unusual situations, which allows it to shed new light on a specific business research problem.

Writing multiple case studies for your business

If you're feeling overwhelmed by the idea of writing a case study and it seems completely foreign, then you aren't alone. Writing a case study for a business is a very big deal, but fortunately, there is help available because an example of a case study doesn't always help.

Mailchimp, a well-known marketing company that provides comprehensive marketing support for all sorts of businesses, can assist you with your case study, or you can review one of their own recently published examples.

Mailchimp can assist you with developing the most effective content strategy to increase your chances of being as successful as possible. Mailchimp's content studio is a great tool that can help your business immensely.

Case Study Methods and Examples

By Janet Salmons, PhD Manager, Sage Research Methods Community

What is Case Study Methodology ?

Case studies in research are both unique and uniquely confusing. The term case study is confusing because the same term is used multiple ways. The term can refer to the methodology, that is, a system of frameworks used to design a study, or the methods used to conduct it. Or, case study can refer to a type of academic writing that typically delves into a problem, process, or situation.

Case study methodology can entail the study of one or more "cases," that could be described as instances, examples, or settings where the problem or phenomenon can be examined. The researcher is tasked with defining the parameters of the case, that is, what is included and excluded. This process is called bounding the case , or setting boundaries.

Case study can be combined with other methodologies, such as ethnography, grounded theory, or phenomenology. In such studies the research on the case uses another framework to further define the study and refine the approach.

Case study is also described as a method, given particular approaches used to collect and analyze data. Case study research is conducted by almost every social science discipline: business, education, sociology, psychology. Case study research, with its reliance on multiple sources, is also a natural choice for researchers interested in trans-, inter-, or cross-disciplinary studies.

The Encyclopedia of case study research provides an overview:

The purpose of case study research is twofold: (1) to provide descriptive information and (2) to suggest theoretical relevance. Rich description enables an in-depth or sharpened understanding of the case.

It is unique given one characteristic: case studies draw from more than one data source. Case studies are inherently multimodal or mixed methods because this they use either more than one form of data within a research paradigm, or more than one form of data from different paradigms.

A case study inquiry could include multiple types of data:

multiple forms of quantitative data sources, such as Big Data + a survey

multiple forms of qualitative data sources, such as interviews + observations + documents

multiple forms of quantitative and qualitative data sources, such as surveys + interviews

Case study methodology can be used to achieve different research purposes.

Robert Yin , methodologist most associated with case study research, differentiates between descriptive , exploratory and explanatory case studies:

Descriptive : A case study whose purpose is to describe a phenomenon. Explanatory : A case study whose purpose is to explain how or why some condition came to be, or why some sequence of events occurred or did not occur. Exploratory: A case study whose purpose is to identify the research questions or procedures to be used in a subsequent study.

Robert Yin’s book is a comprehensive guide for case study researchers!

You can read the preface and Chapter 1 of Yin's book here . See the open-access articles below for some published examples of qualitative, quantitative, and mixed methods case study research.

Mills, A. J., Durepos, G., & Wiebe, E. (2010).  Encyclopedia of case study research (Vols. 1-0). Thousand Oaks, CA: SAGE Publications, Inc. doi: 10.4135/9781412957397

Yin, R. K. (2018). Case study research and applications (6th ed.). Thousand Oaks: SAGE Publications.

Open-Access Articles Using Case Study Methodology

As you can see from this collection, case study methods are used in qualitative, quantitative and mixed methods research.

Ang, C.-S., Lee, K.-F., & Dipolog-Ubanan, G. F. (2019). Determinants of First-Year Student Identity and Satisfaction in Higher Education: A Quantitative Case Study. SAGE Open. https://doi.org/10.1177/2158244019846689

Abstract. First-year undergraduates’ expectations and experience of university and student engagement variables were investigated to determine how these perceptions influence their student identity and overall course satisfaction. Data collected from 554 first-year undergraduates at a large private university were analyzed. Participants were given the adapted version of the Melbourne Centre for the Study of Higher Education Survey to self-report their learning experience and engagement in the university community. The results showed that, in general, the students’ reasons of pursuing tertiary education were to open the door to career opportunities and skill development. Moreover, students’ views on their learning and university engagement were at the moderate level. In relation to student identity and overall student satisfaction, it is encouraging to state that their perceptions of studentship and course satisfaction were rather positive. After controlling for demographics, student engagement appeared to explain more variance in student identity, whereas students’ expectations and experience explained greater variance in students’ overall course satisfaction. Implications for practice, limitations, and recommendation of this study are addressed.

Baker, A. J. (2017). Algorithms to Assess Music Cities: Case Study—Melbourne as a Music Capital. SAGE Open. https://doi.org/10.1177/2158244017691801

Abstract. The global  Mastering of a Music City  report in 2015 notes that the concept of music cities has penetrated the global political vernacular because it delivers “significant economic, employment, cultural and social benefits.” This article highlights that no empirical study has combined all these values and offers a relevant and comprehensive definition of a music city. Drawing on industry research,1 the article assesses how mathematical flowcharts, such as Algorithm A (Economics), Algorithm B (Four T’s creative index), and Algorithm C (Heritage), have contributed to the definition of a music city. Taking Melbourne as a case study, it illustrates how Algorithms A and B are used as disputed evidence about whether the city is touted as Australia’s music capital. The article connects the three algorithms to an academic framework from musicology, urban studies, cultural economics, and sociology, and proposes a benchmark Algorithm D (Music Cities definition), which offers a more holistic assessment of music activity in any urban context. The article concludes by arguing that Algorithm D offers a much-needed definition of what comprises a music city because it builds on the popular political economy focus and includes the social importance of space and cultural practices.

Brown, K., & Mondon, A. (2020). Populism, the media, and the mainstreaming of the far right: The Guardian’s coverage of populism as a case study. Politics. https://doi.org/10.1177/0263395720955036

Abstract. Populism seems to define our current political age. The term is splashed across the headlines, brandished in political speeches and commentaries, and applied extensively in numerous academic publications and conferences. This pervasive usage, or populist hype, has serious implications for our understanding of the meaning of populism itself and for our interpretation of the phenomena to which it is applied. In particular, we argue that its common conflation with far-right politics, as well as its breadth of application to other phenomena, has contributed to the mainstreaming of the far right in three main ways: (1) agenda-setting power and deflection, (2) euphemisation and trivialisation, and (3) amplification. Through a mixed-methods approach to discourse analysis, this article uses  The Guardian  newspaper as a case study to explore the development of the populist hype and the detrimental effects of the logics that it has pushed in public discourse.

Droy, L. T., Goodwin, J., & O’Connor, H. (2020). Methodological Uncertainty and Multi-Strategy Analysis: Case Study of the Long-Term Effects of Government Sponsored Youth Training on Occupational Mobility. Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique, 147–148(1–2), 200–230. https://doi.org/10.1177/0759106320939893

Abstract. Sociological practitioners often face considerable methodological uncertainty when undertaking a quantitative analysis. This methodological uncertainty encompasses both data construction (e.g. defining variables) and analysis (e.g. selecting and specifying a modelling procedure). Methodological uncertainty can lead to results that are fragile and arbitrary. Yet, many practitioners may be unaware of the potential scale of methodological uncertainty in quantitative analysis, and the recent emergence of techniques for addressing it. Recent proposals for ‘multi-strategy’ approaches seek to identify and manage methodological uncertainty in quantitative analysis. We present a case-study of a multi-strategy analysis, applied to the problem of estimating the long-term impact of 1980s UK government-sponsored youth training. We use this case study to further highlight the problem of cumulative methodological fragilities in applied quantitative sociology and to discuss and help develop multi-strategy analysis as a tool to address them.

Ebneyamini, S., & Sadeghi Moghadam, M. R. (2018). Toward Developing a Framework for Conducting Case Study Research .  International Journal of Qualitative Methods .  https://doi.org/10.1177/1609406918817954

Abstract. This article reviews the use of case study research for both practical and theoretical issues especially in management field with the emphasis on management of technology and innovation. Many researchers commented on the methodological issues of the case study research from their point of view thus, presenting a comprehensive framework was missing. We try representing a general framework with methodological and analytical perspective to design, develop, and conduct case study research. To test the coverage of our framework, we have analyzed articles in three major journals related to the management of technology and innovation to approve our framework. This study represents a general structure to guide, design, and fulfill a case study research with levels and steps necessary for researchers to use in their research.

Lai, D., & Roccu, R. (2019). Case study research and critical IR: the case for the extended case methodology. International Relations , 33 (1), 67-87. https://doi.org/10.1177/0047117818818243

Abstract. Discussions on case study methodology in International Relations (IR) have historically been dominated by positivist and neopositivist approaches. However, these are problematic for critical IR research, pointing to the need for a non-positivist case study methodology. To address this issue, this article introduces and adapts the extended case methodology as a critical, reflexivist approach to case study research, whereby the case is constructed through a dynamic interaction with theory, rather than selected, and knowledge is produced through extensions rather than generalisation. Insofar as it seeks to study the world in complex and non-linear terms, take context and positionality seriously, and generate explicitly political and emancipatory knowledge, the extended case methodology is consistent with the ontological and epistemological commitments of several critical IR approaches. Its potential is illustrated in the final part of the article with reference to researching the socioeconomic dimension of transitional justice in Bosnia and Herzegovina.

Lynch, R., Young, J. C., Boakye-Achampong, S., Jowaisas, C., Sam, J., & Norlander, B. (2020). Benefits of crowdsourcing for libraries: A case study from Africa . IFLA Journal. https://doi.org/10.1177/0340035220944940

Abstract. Many libraries in the Global South do not collect comprehensive data about themselves, which creates challenges in terms of local and international visibility. Crowdsourcing is an effective tool that engages the public to collect missing data, and it has proven to be particularly valuable in countries where governments collect little public data. Whereas crowdsourcing is often used within fields that have high levels of development funding, such as health, the authors believe that this approach would have many benefits for the library field as well. They present qualitative and quantitative evidence from 23 African countries involved in a crowdsourcing project to map libraries. The authors find benefits in terms of increased connections between stakeholders, capacity-building, and increased local visibility. These findings demonstrate the potential of crowdsourced approaches for tasks such as mapping to benefit libraries and similarly positioned institutions in the Global South in multifaceted ways.

Mason, W., Morris, K., Webb, C., Daniels, B., Featherstone, B., Bywaters, P., Mirza, N., Hooper, J., Brady, G., Bunting, L., & Scourfield, J. (2020). Toward Full Integration of Quantitative and Qualitative Methods in Case Study Research: Insights From Investigating Child Welfare Inequalities. Journal of Mixed Methods Research, 14 (2), 164-183. https://doi.org/10.1177/1558689819857972

Abstract. Delineation of the full integration of quantitative and qualitative methods throughout all stages of multisite mixed methods case study projects remains a gap in the methodological literature. This article offers advances to the field of mixed methods by detailing the application and integration of mixed methods throughout all stages of one such project; a study of child welfare inequalities. By offering a critical discussion of site selection and the management of confirmatory, expansionary and discordant data, this article contributes to the limited body of mixed methods exemplars specific to this field. We propose that our mixed methods approach provided distinctive insights into a complex social problem, offering expanded understandings of the relationship between poverty, child abuse, and neglect.

Rashid, Y., Rashid, A., Warraich, M. A., Sabir, S. S., & Waseem, A. (2019). Case Study Method: A Step-by-Step Guide for Business Researchers .  International Journal of Qualitative Methods .  https://doi.org/10.1177/1609406919862424

Abstract. Qualitative case study methodology enables researchers to conduct an in-depth exploration of intricate phenomena within some specific context. By keeping in mind research students, this article presents a systematic step-by-step guide to conduct a case study in the business discipline. Research students belonging to said discipline face issues in terms of clarity, selection, and operationalization of qualitative case study while doing their final dissertation. These issues often lead to confusion, wastage of valuable time, and wrong decisions that affect the overall outcome of the research. This article presents a checklist comprised of four phases, that is, foundation phase, prefield phase, field phase, and reporting phase. The objective of this article is to provide novice researchers with practical application of this checklist by linking all its four phases with the authors’ experiences and learning from recently conducted in-depth multiple case studies in the organizations of New Zealand. Rather than discussing case study in general, a targeted step-by-step plan with real-time research examples to conduct a case study is given.

VanWynsberghe, R., & Khan, S. (2007). Redefining Case Study. International Journal of Qualitative Methods, 80–94. https://doi.org/10.1177/160940690700600208

Abstract. In this paper the authors propose a more precise and encompassing definition of case study than is usually found. They support their definition by clarifying that case study is neither a method nor a methodology nor a research design as suggested by others. They use a case study prototype of their own design to propose common properties of case study and demonstrate how these properties support their definition. Next, they present several living myths about case study and refute them in relation to their definition. Finally, they discuss the interplay between the terms case study and unit of analysis to further delineate their definition of case study. The target audiences for this paper include case study researchers, research design and methods instructors, and graduate students interested in case study research.

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• a study of an individual unit, as a person, family, or social group, usually emphasizing developmental issues and relationships with the environment, especially in order to compare a larger group to the individual unit.
• case history .
• the act or an instance of analysing one or more particular cases or case histories with a view to making generalizations

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Origin of case study 1

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In a case study from Metric Theory, Target Impression Share bidding, the total cost per click increased with both mobile and desktop devices.

It would also become the subject of a fair number of business school case studies.

Not just blog posts, you can also share other resources like case studies, podcast episodes, and webinars via Instagram Stories.

They become the architecture for a case study of Flint, expressed in a more personal and poetic way than a straightforward investigation could.

The Creek Fire was a case study in the challenge facing today’s fire analysts, who are trying to predict the movements of fires that are far more severe than those seen just a decade ago.

A case study would be your Twilight director Catherine Hardwicke.

A good case study for the minority superhero problem is Luke Cage.

He was asked to review a case study out of Lebanon that had cited his work.

Instead, now we have a political science case-study proving how political fortunes can shift and change at warp speed.

One interesting case study is Sir Arthur Evans, the original excavator and “restorer” of the Minoan palace of Knossos on Crete.

As this is a case study, it should be said that my first mistake was in discrediting my early religious experience.

The author of a recent case study of democracy in a frontier county commented on the need for this kind of investigation.

How could a case study of Virginia during this period illustrate these developments?

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Blog Beginner Guides What is a Case Study? [+6 Types of Case Studies]

What is a Case Study? [+6 Types of Case Studies]

Written by: Ronita Mohan Sep 20, 2021

Case studies have become powerful business tools. But what is a case study? What are the benefits of creating one? Are there limitations to the format?

If you’ve asked yourself these questions, our helpful guide will clear things up. Learn how to use a case study for business. Find out how cases analysis works in psychology and research.

We’ve also got examples of case studies to inspire you.

Haven’t made a case study before? You can easily  create a case study  with Venngage’s customizable templates.

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Click to jump ahead:

What is a case study, what is the case study method, benefits of case studies, limitations of case studies, types of case studies, faqs about case studies.

Case studies are research methodologies. They examine subjects, projects, or organizations to tell a story.

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Numerous sectors use case analyses. The social sciences, social work, and psychology create studies regularly.

Healthcare industries write reports on patients and diagnoses. Marketing case study examples , like the one below, highlight the benefits of a business product.

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Now that you know what a case study is, we explain how case reports are used in three different industries.

What is a business case study?

A business or marketing case study aims at showcasing a successful partnership. This can be between a brand and a client. Or the case study can examine a brand’s project.

There is a perception that case studies are used to advertise a brand. But effective reports, like the one below, can show clients how a brand can support them.

Hubspot created a case study on a customer that successfully scaled its business. The report outlines the various Hubspot tools used to achieve these results.

Hubspot also added a video with testimonials from the client company’s employees.

So, what is the purpose of a case study for businesses? There is a lot of competition in the corporate world. Companies are run by people. They can be on the fence about which brand to work with.

Business reports  stand out aesthetically, as well. They use  brand colors  and brand fonts . Usually, a combination of the client’s and the brand’s.

With the Venngage  My Brand Kit  feature, businesses can automatically apply their brand to designs.

A business case study, like the one below, acts as social proof. This helps customers decide between your brand and your competitors.

Don’t know how to design a report? You can learn  how to write a case study  with Venngage’s guide. We also share design tips and examples that will help you convert.

Related: 55+ Annual Report Design Templates, Inspirational Examples & Tips [Updated]

What is a case study in psychology?

In the field of psychology, case studies focus on a particular subject. Psychology case histories also examine human behaviors.

Case reports search for commonalities between humans. They are also used to prescribe further research. Or these studies can elaborate on a solution for a behavioral ailment.

The American Psychology Association  has a number of case studies on real-life clients. Note how the reports are more text-heavy than a business case study.

Famous psychologists such as Sigmund Freud and Anna O popularised the use of case studies in the field. They did so by regularly interviewing subjects. Their detailed observations build the field of psychology.

It is important to note that psychological studies must be conducted by professionals. Psychologists, psychiatrists and therapists should be the researchers in these cases.

Related: What Netflix’s Top 50 Shows Can Teach Us About Font Psychology [Infographic]

What is a case study in research?

Research is a necessary part of every case study. But specific research fields are required to create studies. These fields include user research, healthcare, education, or social work.

For example, this UX Design  report examined the public perception of a client. The brand researched and implemented new visuals to improve it. The study breaks down this research through lessons learned.

Clinical reports are a necessity in the medical field. These documents are used to share knowledge with other professionals. They also help examine new or unusual diseases or symptoms.

The pandemic has led to a significant increase in research. For example,  Spectrum Health  studied the value of health systems in the pandemic. They created the study by examining community outreach.

The pandemic has significantly impacted the field of education. This has led to numerous examinations on remote studying. There have also been studies on how students react to decreased peer communication.

Social work case reports often have a community focus. They can also examine public health responses. In certain regions, social workers study disaster responses.

You now know what case studies in various fields are. In the next step of our guide, we explain the case study method.

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A case analysis is a deep dive into a subject. To facilitate this case studies are built on interviews and observations. The below example would have been created after numerous interviews.

Case studies are largely qualitative. They analyze and describe phenomena. While some data is included, a case analysis is not quantitative.

There are a few steps in the case method. You have to start by identifying the subject of your study. Then determine what kind of research is required.

In natural sciences, case studies can take years to complete. Business reports, like this one, don’t take that long. A few weeks of interviews should be enough.

The case method will vary depending on the industry. Reports will also look different once produced.

As you will have seen, business reports are more colorful. The design is also more accessible . Healthcare and psychology reports are more text-heavy.

Designing case reports takes time and energy. So, is it worth taking the time to write them? Here are the benefits of creating case studies.

• Collects large amounts of information
• Helps formulate hypotheses
• Builds the case for further research
• Discovers new insights into a subject
• Builds brand trust and loyalty
• Engages customers through stories

For example, the business study below creates a story around a brand partnership. It makes for engaging reading. The study also shows evidence backing up the information.

We’ve shared the benefits of why studies are needed. We will also look at the limitations of creating them.

Related: How to Present a Case Study like a Pro (With Examples)

There are a few disadvantages to conducting a case analysis. The limitations will vary according to the industry.

• Responses from interviews are subjective
• Subjects may tailor responses to the researcher
• Studies can’t always be replicated
• In certain industries, analyses can take time and be expensive
• Risk of generalizing the results among a larger population

These are some of the common weaknesses of creating case reports. If you’re on the fence, look at the competition in your industry.

Other brands or professionals are building reports, like this example. In that case, you may want to do the same.

There are six common types of case reports. Depending on your industry, you might use one of these types.

Descriptive case studies

Explanatory case studies, exploratory case reports, intrinsic case studies, instrumental case studies, collective case reports.

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We go into more detail about each type of study in the guide below.

Related:  15+ Professional Case Study Examples [Design Tips + Templates]

When you have an existing hypothesis, you can design a descriptive study. This type of report starts with a description. The aim is to find connections between the subject being studied and a theory.

Once these connections are found, the study can conclude. The results of this type of study will usually suggest how to develop a theory further.

A study like the one below has concrete results. A descriptive report would use the quantitative data as a suggestion for researching the subject deeply.

When an incident occurs in a field, an explanation is required. An explanatory report investigates the cause of the event. It will include explanations for that cause.

The study will also share details about the impact of the event. In most cases, this report will use evidence to predict future occurrences. The results of explanatory reports are definitive.

Note that there is no room for interpretation here. The results are absolute.

The study below is a good example. It explains how one brand used the services of another. It concludes by showing definitive proof that the collaboration was successful.

Another example of this study would be in the automotive industry. If a vehicle fails a test, an explanatory study will examine why. The results could show that the failure was because of a particular part.

Related: How to Write a Case Study [+ Design Tips]

An explanatory report is a self-contained document. An exploratory one is only the beginning of an investigation.

Exploratory cases act as the starting point of studies. This is usually conducted as a precursor to large-scale investigations. The research is used to suggest why further investigations are needed.

An exploratory study can also be used to suggest methods for further examination.

For example, the below analysis could have found inconclusive results. In that situation, it would be the basis for an in-depth study.

Intrinsic studies are more common in the field of psychology. These reports can also be conducted in healthcare or social work.

These types of studies focus on a unique subject, such as a patient. They can sometimes study groups close to the researcher.

The aim of such studies is to understand the subject better. This requires learning their history. The researcher will also examine how they interact with their environment.

For instance, if the case study below was about a unique brand, it could be an intrinsic study.

Once the study is complete, the researcher will have developed a better understanding of a phenomenon. This phenomenon will likely not have been studied or theorized about before.

Examples of intrinsic case analysis can be found across psychology. For example, Jean Piaget’s theories on cognitive development. He established the theory from intrinsic studies into his own children.

Related: What Disney Villains Can Tell Us About Color Psychology [Infographic]

This is another type of study seen in medical and psychology fields. Instrumental reports are created to examine more than just the primary subject.

When research is conducted for an instrumental study, it is to provide the basis for a larger phenomenon. The subject matter is usually the best example of the phenomenon. This is why it is being studied.

Assume it’s examining lead generation strategies. It may want to show that visual marketing is the definitive lead generation tool. The brand can conduct an instrumental case study to examine this phenomenon.

Collective studies are based on instrumental case reports. These types of studies examine multiple reports.

There are a number of reasons why collective reports are created:

• To provide evidence for starting a new study
• To find pattens between multiple instrumental reports
• To find differences in similar types of cases
• Gain a deeper understanding of a complex phenomenon
• Understand a phenomenon from diverse contexts

A researcher could use multiple reports, like the one below, to build a collective case report.

Related: 10+ Case Study Infographic Templates That Convert

What makes a case study a case study?

A case study has a very particular research methodology. They are an in-depth study of a person or a group of individuals. They can also study a community or an organization. Case reports examine real-world phenomena within a set context.

How long should a case study be?

The length of studies depends on the industry. It also depends on the story you’re telling. Most case studies should be at least 500-1500 words long. But you can increase the length if you have more details to share.

What should you ask in a case study?

The one thing you shouldn’t ask is ‘yes’ or ‘no’ questions. Case studies are qualitative. These questions won’t give you the information you need.

Ask your client about the problems they faced. Ask them about solutions they found. Or what they think is the ideal solution. Leave room to ask them follow-up questions. This will help build out the study.

How to present a case study?

When you’re ready to present a case study, begin by providing a summary of the problem or challenge you were addressing. Follow this with an outline of the solution you implemented, and support this with the results you achieved, backed by relevant data. Incorporate visual aids like slides, graphs, and images to make your case study presentation more engaging and impactful.

Now you know what a case study means, you can begin creating one. These reports are a great tool for analyzing brands. They are also useful in a variety of other fields.

Use a visual communication platform like Venngage to design case studies. With Venngage’s templates, you can design easily. Create branded, engaging reports, all without design experience.

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• Volume 21, Issue 1
• What is a case study?
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• Roberta Heale 1 ,
• Alison Twycross 2
• 1 School of Nursing , Laurentian University , Sudbury , Ontario , Canada
• 2 School of Health and Social Care , London South Bank University , London , UK
• Correspondence to Dr Roberta Heale, School of Nursing, Laurentian University, Sudbury, ON P3E2C6, Canada; rheale{at}laurentian.ca

https://doi.org/10.1136/eb-2017-102845

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What is it?

Case study is a research methodology, typically seen in social and life sciences. There is no one definition of case study research. 1 However, very simply… ‘a case study can be defined as an intensive study about a person, a group of people or a unit, which is aimed to generalize over several units’. 1 A case study has also been described as an intensive, systematic investigation of a single individual, group, community or some other unit in which the researcher examines in-depth data relating to several variables. 2

Often there are several similar cases to consider such as educational or social service programmes that are delivered from a number of locations. Although similar, they are complex and have unique features. In these circumstances, the evaluation of several, similar cases will provide a better answer to a research question than if only one case is examined, hence the multiple-case study. Stake asserts that the cases are grouped and viewed as one entity, called the quintain . 6  ‘We study what is similar and different about the cases to understand the quintain better’. 6

The steps when using case study methodology are the same as for other types of research. 6 The first step is defining the single case or identifying a group of similar cases that can then be incorporated into a multiple-case study. A search to determine what is known about the case(s) is typically conducted. This may include a review of the literature, grey literature, media, reports and more, which serves to establish a basic understanding of the cases and informs the development of research questions. Data in case studies are often, but not exclusively, qualitative in nature. In multiple-case studies, analysis within cases and across cases is conducted. Themes arise from the analyses and assertions about the cases as a whole, or the quintain, emerge. 6

Benefits and limitations of case studies

If a researcher wants to study a specific phenomenon arising from a particular entity, then a single-case study is warranted and will allow for a in-depth understanding of the single phenomenon and, as discussed above, would involve collecting several different types of data. This is illustrated in example 1 below.

Using a multiple-case research study allows for a more in-depth understanding of the cases as a unit, through comparison of similarities and differences of the individual cases embedded within the quintain. Evidence arising from multiple-case studies is often stronger and more reliable than from single-case research. Multiple-case studies allow for more comprehensive exploration of research questions and theory development. 6

Despite the advantages of case studies, there are limitations. The sheer volume of data is difficult to organise and data analysis and integration strategies need to be carefully thought through. There is also sometimes a temptation to veer away from the research focus. 2 Reporting of findings from multiple-case research studies is also challenging at times, 1 particularly in relation to the word limits for some journal papers.

Examples of case studies

Example 1: nurses’ paediatric pain management practices.

One of the authors of this paper (AT) has used a case study approach to explore nurses’ paediatric pain management practices. This involved collecting several datasets:

Observational data to gain a picture about actual pain management practices.

Questionnaire data about nurses’ knowledge about paediatric pain management practices and how well they felt they managed pain in children.

Questionnaire data about how critical nurses perceived pain management tasks to be.

These datasets were analysed separately and then compared 7–9 and demonstrated that nurses’ level of theoretical did not impact on the quality of their pain management practices. 7 Nor did individual nurse’s perceptions of how critical a task was effect the likelihood of them carrying out this task in practice. 8 There was also a difference in self-reported and observed practices 9 ; actual (observed) practices did not confirm to best practice guidelines, whereas self-reported practices tended to.

Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics (NPLCs)

The other author of this paper (RH) has conducted a multiple-case study to determine the quality of care for patients with complex clinical presentations in NPLCs in Ontario, Canada. 10 Five NPLCs served as individual cases that, together, represented the quatrain. Three types of data were collected including:

Review of documentation related to the NPLC model (media, annual reports, research articles, grey literature and regulatory legislation).

Interviews with nurse practitioners (NPs) practising at the five NPLCs to determine their perceptions of the impact of the NPLC model on the quality of care provided to patients with multimorbidity.

Chart audits conducted at the five NPLCs to determine the extent to which evidence-based guidelines were followed for patients with diabetes and at least one other chronic condition.

The three sources of data collected from the five NPLCs were analysed and themes arose related to the quality of care for complex patients at NPLCs. The multiple-case study confirmed that nurse practitioners are the primary care providers at the NPLCs, and this positively impacts the quality of care for patients with multimorbidity. Healthcare policy, such as lack of an increase in salary for NPs for 10 years, has resulted in issues in recruitment and retention of NPs at NPLCs. This, along with insufficient resources in the communities where NPLCs are located and high patient vulnerability at NPLCs, have a negative impact on the quality of care. 10

These examples illustrate how collecting data about a single case or multiple cases helps us to better understand the phenomenon in question. Case study methodology serves to provide a framework for evaluation and analysis of complex issues. It shines a light on the holistic nature of nursing practice and offers a perspective that informs improved patient care.

• Gustafsson J
• Calanzaro M
• Sandelowski M

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

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What the Case Study Method Really Teaches

• Nitin Nohria

Seven meta-skills that stick even if the cases fade from memory.

It’s been 100 years since Harvard Business School began using the case study method. Beyond teaching specific subject matter, the case study method excels in instilling meta-skills in students. This article explains the importance of seven such skills: preparation, discernment, bias recognition, judgement, collaboration, curiosity, and self-confidence.

During my decade as dean of Harvard Business School, I spent hundreds of hours talking with our alumni. To enliven these conversations, I relied on a favorite question: “What was the most important thing you learned from your time in our MBA program?”

• Nitin Nohria is the George F. Baker Professor of Business Administration, Distinguished University Service Professor, and former dean of Harvard Business School.

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Man or bear? Hypothetical question sparks conversation about women's safety

Women explain why they would feel safer encountering a bear in the forest than a man they didn't know. the hypothetical has sparked a broader discussion about why women fear men..

If you were alone in the woods, would you rather encounter a bear or a man? Answers to that hypothetical question have sparked a debate about why the vast majority say they would feel more comfortable choosing a bear.

The topic has been hotly discussed for weeks as men and women chimed in with their thoughts all over social media.

Screenshot HQ , a TikTok account, started the conversation, asking a group of women whether they would rather run into a man they didn't know or a bear in the forest. Out of the seven women interviewed for the piece, only one picked a man.

"Bear. Man is scary," one of the women responds.

A number of women echoed the responses given in the original video, writing in the comments that they, too, would pick a bear over a man. The hypothetical has people split, with some expressing their sadness over the state of the world and others cracking jokes. Some men were flabbergasted.

Here's what we know.

A bear is the safer choice, no doubt about it, many say

There were a lot of responses, more than 65,000, under the original post. Many wrote that they understood why the women would choose a bear.

"No one’s gonna ask me if I led the bear on or give me a pamphlet on bear attack prevention tips," @celestiallystunning wrote.

@Brennduhh wrote: "When I die leave my body in the woods, the wolves will be gentler than any man."

"I know a bear's intentions," another woman wrote. "I don't know a man's intentions. no matter how nice they are."

Other TikTok users took it one step further, posing the hypothetical question to loved ones. Meredith Steele, who goes by @babiesofsteele , asked her husband last week whether he would rather have their daughter encounter a bear or a man in the woods. Her husband said he "didn't like either option" but said he was leaning toward the bear.

"Maybe it's a friendly bear," he says.

Diana, another TikTok user , asked her sister-in-law what she would choose and was left speechless.

"I asked her the question, you know, just for giggles. She was like, 'You know, I would rather it be a bear because if the bear attacks me, and I make it out of the woods, everybody’s gonna believe me and have sympathy for me," she said. "But if a man attacks me and I make it out, I’m gonna spend my whole life trying to get people to believe me and have sympathy for me.'"

Bear vs. man debate stirs the pot, woman and some men at odds

The hypothetical has caused some tension, with some women arguing that men will never truly understand what it's like to be a woman or the inherent dangers at play.

Social media users answered this question for themselves, producing memes, spoken word poetry and skits in the days and weeks since.

So, what would you choose?

Adverse childhood experiences and risk of late-life dementia: a systematic review and meta-analysis

• Open access
• Published: 08 May 2024

Cite this article

You have full access to this open access article

• Moaz Elsayed Abouelmagd   ORCID: orcid.org/0000-0002-0511-2429 1 ,
• Maickel AbdelMeseh   ORCID: orcid.org/0000-0002-4703-4203 2   na1 ,
• Amr Elrosasy   ORCID: orcid.org/0000-0002-5592-3908 1 ,
• Hatem Abdelmoneim Eldeeb   ORCID: orcid.org/0000-0001-6270-3180 3 &
• Yehia Nabil   ORCID: orcid.org/0000-0002-1349-2978 4  

Adverse childhood experiences (ACEs) refer to distressing events before age 18 that can lead to potential mental and physical health consequences. This systematic review and meta-analysis aimed to examine the association between ACEs and the risk of dementia in elderly adults who experienced ACEs during childhood, addressing the existing inconsistencies and methodological variations.

A comprehensive search strategy was employed across key databases (PubMed, Web of Science, Scopus, and Embase) to identify relevant articles. Our primary outcome was ACEs-dementia risk, and our secondary outcome was mild cognitive impairment risk. A quality assessment was conducted using the Newcastle–Ottawa Quality Assessment Scale and GRADE. A random-effects model was utilized to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses were performed to explore potential sources of heterogeneity and assess the reliability of the results.

Out of 1,376 screened papers, nine studies were included. The studies consisted of two case-control, one prospective cohort, and six retrospective cohort studies conducted in the UK, France, USA, China, and Spain. Five studies were of good methodological quality according to the NOS. according to the GRADE, all outcomes were classified as very low or low quality of evidence. A significant association was observed between ACEs and dementia risk (OR = 1.35; 95% CI 1.20, 1.52; P  = 0.00001) and mild cognitive impairment risk (OR = 1.28; 95% CI 0.63, 2.62; P  = 0.49). A meta-analysis by type of adversity revealed significant results for the maltreatment subgroup(OR = 1.30; 95% CI 0.07-1.58; P  = 0.007; I² = 0%). Subgroup analysis based on the dementia definition revealed no between-subgroup difference ( P  = 0.71) between tool-based and register/criteria-based subgroups. No possibility of Publication bias was observed upon inspection of the funnel plot.

Adverse childhood experiences may be associated with an increased risk of dementia. However, caution is warranted in interpreting these results due to the limited number of studies. Larger high-quality studies investigating the association between ACEs and dementia risk are needed to confirm the reliability of our results.

Avoid common mistakes on your manuscript.

Introduction

Adverse childhood experiences (ACEs) encompass a range of stressful and traumatic events that have significant implications for the health of adolescents and adults. Globally, approximately one billion children aged between two and seventeen years are estimated to have experienced such violence at least once, with rates of 58% in North America and 42% in Europe [ 1 , 2 ]. These experiences include various forms of abuse (physical and emotional), neglect (physical and emotional), household dysfunction (such as substance misuse, incarceration, chronic depression or mental illness, domestic violence, and disrupted family structure), and exposure to bullying and community violence [ 3 ].

Dementia, a neurodegenerative disease characterized by cognitive decline, represents a major global health concern. In 2015 alone, 47 million individuals were affected, with projections indicating that this number will triple by 2050 [ 4 ]. Dementia has been associated with structural and functional alterations in brain regions involved in cognition, including the hippocampus and prefrontal cortex, the same areas affected by childhood stress. These findings suggest that early life adversities may serve as risk factors for the development of dementia and cognitive impairment later in life [ 5 , 6 ].

Stress and trauma have been linked to an increased risk of developing dementia. A recent meta-analysis (MA) revealed that the risk of dementia in individuals with posttraumatic stress disorder is 1.61–1.99 times greater than the risk in people without this disorder [ 7 ]. Childhood represents a crucial period in human development during which neurological connections are established. Any events occurring during this time can have long-lasting effects on health outcomes. A recent study has shown that ACEs are linked to an increased need for specialized healthcare, such as prescription medication, special therapies, and additional support services [ 8 ].

Although the exact connection between psychological trauma and dementia is not yet fully understood, proposed mechanisms suggest that neurobiological activity may be altered, stress-related pathways may be affected, cognitive stimulation may be reduced, and shared genetic vulnerabilities may play a role [ 7 ]. Furthermore, ACEs may impact dementia risk by influencing other associated risk factors. A recent study revealed that ACEs were positively correlated with increased dementia risk factors, including lower educational attainment, limited social contact, smoking, and clinical depression [ 9 ].

While previous systematic reviews have provided valuable qualitative insights into the relationship between ACEs and cognitive functions and Alzheimer’s disease in late life [ 10 , 11 ], there is currently a lack of MA studies specifically examining the association between ACEs and the risk of developing dementia. Our systematic review and meta-analysis aims to fill this gap and provide a more comprehensive understanding of how ACEs impact the likelihood of developing dementia in late life.

In this study, we followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Cochrane Handbook of Systematic Review and Meta-analysis. We registered the detailed protocol of this MA on open science framework (OSF) with the following DOI: https://doi.org/10.17605/OSF.IO/6EBDZ .

Search strategy

A comprehensive search was conducted across major electronic databases (PubMed, Web of Science, Scopus, and Embase) for relevant keywords from conception through the 15th of December 2023.

For example, the PubMed search strategy used was as follows: ((childhood OR Child OR children OR “early life”) AND (Maltreatment OR adversity OR violence OR Trauma OR “Adverse childhood” OR neglect OR ACEs OR abuse OR stress) AND (Alzheimer OR dementia OR cognitive decline OR MCI) AND (observational OR COHORT OR CASE-CONTROL OR “case-control” OR RCT OR TRIAL OR register). Additionally, the references of the included studies were screened for potential articles to include.

Study selection

To select the most relevant studies for this research, the titles and abstracts of the retrieved records from the search strategy were imported into Rayyan [ 12 ], an online platform for screening studies in systematic reviews. Duplicate records were eliminated, and two authors independently screened all abstracts. Conflicts were resolved by the first author. Subsequently, eligible studies underwent a full-text screening phase based on predefined inclusion and exclusion criteria.

Inclusion criteria

English-language studies published in peer-reviewed journals.

Participants experienced adverse childhood experiences (ACEs) before the age of 18, including violence, abuse, neglect, witnessing violence in the home, family member’s death, living in an unstable house with substance use/mentally ill/incarcerated parents, traumatic experiences, etc.

Participants aged > 60 at follow-up.

Dementia or cognitive impairment was defined using validated diagnostic criteria, tools, or medical records.

The studies included sufficient data, such as odds ratios (ORs), risk ratios (RRs), hazard ratios (HRs), or data for calculation.

Longitudinal study design (case-control or cohort).

A healthy control group was included.

Exclusion criteria

Studies that focused on head trauma, childhood diseases, or physical injury that may lead to dementia or mild cognitive impairment (MCI).

Studies on high-risk medical populations (e.g., diabetes, hypertension).

The full texts of the studies were unavailable after contacting the corresponding author.

Data extraction

Two authors extracted relevant data from the included studies into a data extraction Google Sheet. The extracted data for each study included the study ID, study design, country, baseline characteristics, sociodemographic characteristics, measurement tools for cognition and early-life adversity, number of participants, length of follow-up, adjustment factors, outcomes, and key findings.

Methodological quality assessment

We used the Newcastle–Ottawa Quality Assessment Scale (NOS) to assess the quality of the studies. The NOS consists of eight questions. This scale evaluates three parameters of quality (selection, comparability, and outcome) and includes specific items that vary slightly for case-control and cohort studies. Each item on the scale can receive a maximum score of 1 point, except for comparability, which can be adjusted to the specific topic of interest, and a maximum score of 2 points, with the highest overall score being 9 [ 13 ]. To convert the NOS to fit the standards set by the Agency for Healthcare Research and Quality—good, fair, and poor—the following thresholds are applied [ 14 ]:

Good quality: 3 or 4 stars in the selection domain 1 or 2 stars in the comparability domain AND 2 or 3 stars in the outcome/exposure domain.

Fair quality: 2 stars in the selection domain 1 or 2 stars in the comparability domain AND 2 or 3 stars in the outcome/exposure domain.

Poor quality: 0 or 1 star in the selection domain; 0 stars in the comparability domain; and 0 or 1 star in the outcome/exposure domain.

Additionally, the GRADE approach was applied to rate the overall quality of evidence and strength of recommendations for each outcome of interest. This approach considers factors such as risk of bias, inconsistency, indirectness, imprecision, and publication bias. The confidence in the estimates is categorized as high, moderate, low, or very low [ 15 ].

Statistical analysis

The primary outcome of interest was the odds of dementia in ACEs-exposed elderly individuals with 2 or more ACEs, and the secondary outcome was the odds of MCI in ACEs-exposed elderly individuals. The effect sizes of the included studies were expressed as odds ratios (ORs), risk ratios (RRs), or hazard ratios (HRs). If multiple outcomes were reported, the outcomes with the best diagnostic criteria, highest number of cases, and best adjustment were chosen. An OR of 1 indicates no association, an OR between 0 and 1 indicates a negative relationship and an OR greater than 1 indicates a positive relationship, indicating that early-life adversity is associated with a greater risk of dementia/MCI.

Heterogeneity between studies was assessed visually using forest plots and the I² test. I² values less than 50% indicated insignificant heterogeneity, while values ≥ 50% indicated substantial heterogeneity. A random-effects model (DerSimonian‒Laird) was used to calculate the pooled OR and 95% confidence interval (CI) to account for within- and between-study heterogeneity originating from different effect sizes and/or ACE measurement tools. Sensitivity and subgroup analyses were performed to investigate potential sources of heterogeneity and to test the stability of the results. Subgroup analyses were also conducted for primary outcomes based on the type of adversity, definition of dementia, and quality of evidence if there were at least 2 studies for each subgroup.

Publication Bias

Funnel plots of the primary MA model were visually examined to assess potential publication bias. The uneven distribution of studies around the pooled effect estimate suggested the possibility of publication bias. Additionally, Egger’s test was used.

Search results and characteristics of the included studies

We retrieved 1376 papers through a literature search; 327 of these were duplicates, and we ultimately included nine studies [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ] that presented data from 283,108 participants in the MA (see Fig.  1 ; Table  1 ). We included two case-control studies [ 21 , 23 ], one prospective cohort study [ 19 ], and six retrospective cohort studies [ 16 , 17 , 18 , 20 , 22 , 24 ]. The studies included data from various countries, such as the UK, France, the USA, China, and Spain. The detailed characteristics of the included studies are shown in (Table  1 . )

upward is the PRISMA flow diagram showing the details of the study selection process. Downward is the quality assessment summary of the included studies according to the Newcastle-Ottawa Quality Assessment Scale

Quality assessment of the included studies

Among the cohort and case-control studies, six were classified as having good or fair methodological quality [ 16 , 17 , 19 , 20 , 21 , 24 ] (see Fig.  1 ; Table  1 ). These studies exhibited strong adherence to methodological principles and minimal risk of bias, while the remaining studies were categorized as poor quality [ 18 , 22 , 23 ]. According to the GRADE system, all the included outcomes yielded very low-quality evidence. The details and explanations are clarified in Table  2 .

Risk of dementia and MCI

Seven studies were included in the dementia risk analysis [ 16 , 17 , 18 , 19 , 20 , 22 , 24 ], and 2 studies were included in the MCI analysis [ 23 , 24 ]. All the studies examined ACEs as a cumulative score of 2 or more ACEs through questionnaires containing several domains. However, one study was excluded from this analysis because it measured only 1 adverse event—parents’ death—to avoid heterogeneity [ 21 ]. The definition of dementia or MCI was based on screening tools [diagnosis by a neurologist or registers using International Classification-of-diseases Version 8 (ICD-8)]. The results showed that exposure to ACEs was associated with dementia risk (OR = 1.38; 95% CI 1.25–1.52); P  < 0.00001), with no significant heterogeneity (I2 = 0%). However, there was no significant difference in the risk of developing MCI (OR = 1.28; 95% CI 0.63–2.62); P  = 0.49), and there was moderate heterogeneity (I² = 51%, P  = 0.15) (Fig.  2 ) .

Forrest plot of the association between ACEs and risk of Dementia and Mild cognitive impairment

Publication bias

Inspection of the funnel plot of dementia risk outcome didn’t reveal significant asymmetry and the results of Egger’s test were not significant ( P  = 0.473). (Fig.  3 )

Publication bias of the association between ACEs and dementia risk

Risk of dementia based on type of adversity

Six studies reported specific types of childhood adversity, especially childhood maltreatment and the death of a parent. Childhood maltreatment showed a slight significant association with the risk of dementia (OR = 1.30; 95% CI 0.07-1.58; P  = 0.007; I² = 0%), while the death of a parent showed no significant association (OR = 1.15; 95% CI 0.76–1.73; P  = 0.002; I² = 84%). The test of subgroup differences was not significant (0.58). Heterogeneity was resolved in the second subgroup after excluding Conde-Sala 2020 in the second subgroup [ 23 ] (supplementary material Fig.  1 , Fig.  2 ).

Risk of dementia based on the definition of dementia

Seven studies were included in the subgroup analysis based on the definition of dementia. Three studies defined dementia through registries and diagnostic criteria, while 4 studies defined dementia based on cutoff points of screening tools. The tool-based subgroup exhibited a significant association between ACEs and dementia (OR = 1.41; 95% CI 1.25–1.60; P < 0.00001; I² = 0%), but the register-based subgroup did not exhibit a significant difference (OR = 1.30; 95% CI 0.86–1.97; P = 0.49; I² = 42%). No significant heterogeneity was found in either subgroup analysis, and the test for subgroup differences was not significant (P = 0.71). (supplementary material Fig.  3 )

Risk of dementia based on the quality of the included studies

Seven studies were included in the subgroup analysis based on the quality of the studies: 5 were of good or fair quality, and 2 were of low quality. The associations between ACEs and the risk of dementia were significant in both the good/fair subgroup (OR = 1.31; 95% CI 1.11–1.53; P < 0.0010; I² = 33%) and the low subgroup (OR = 1.41; 95% CI 1.17–1.71; P = 0.0004; I² = 0%). The test of subgroup differences was not significant (P = 0.74), and no significant heterogeneity was found within the subgroups (supplementary material Fig.  4 ).

Recent research predicts that the prevention of ACEs is associated with depression, stroke, coronary heart disease, diabetes, and obesity [ 25 , 26 ]. Our MA aimed to investigate the association between ACEs and the risk of developing dementia and MCI in adulthood. We found a significant relationship between exposure to ACEs and an increased risk of dementia. Subgroup analyses were also conducted to explore specific adverse events, diagnostic criteria, and study quality.

In terms of specific childhood adversities, our findings showed that childhood maltreatment was slightly significantly associated with increased dementia risk, while the death of a parent was not. However, these results are limited by the low number of included studies in each of these analyses and should be interpreted with caution. Regarding diagnostic criteria, individuals diagnosed based on tools showed a significant association, while those diagnosed based on registers did not. When considering study quality, both acceptable and low-quality studies demonstrated a significant association with the risk of dementia. Although most of the studies in our analysis adjusted their results for more than 3 factors, there may be other confounding factors that drive the relationship between traumatic experiences and dementia, which were not adequately accounted for in the analyzed studies.

Three studies [ 16 , 17 , 19 ] in our primary analysis of dementia reported outcomes as cumulative ACEs score > 3 experiences. While three of them reported significant results, Nilaweera et al. [ 17 ]. did not. This study was of good quality and used the largest questionnaire of 25 items for adversity. The absence of findings is mostly due to selection bias, as authors included only participants older than 65 years at baseline who were followed up for 14 years. This may have induced selection bias, as participants who had dementia were excluded during the selection stage.

Pilleron et al. [ 24 ]. also did not find significant results for dementia but did find significant results for MCI. This may be attributed to the limited number and types of adversities asked about in their questionnaire. This questionnaire included five life events before the age of 16 (death of a parent, divorce of parents, growing up with one parent, different guardians, and extreme poverty); these five life events are substantially different from the other measurement tools used in our primary MA, where most studies included questions about emotional, physical and/or sexual abuse.

Yuan et al . reported an independent relationship between ‘Child abuse’ and a higher risk of cognitive impairment in elderly Chinese people, which our pooled analysis confirmed. Conde-Sala et al . reported an increased risk of dementia associated with early parental death. However, our MA did not find a significant relationship between maltreatment or parental death and an increasing risk of dementia.

Various methods were employed to measure ACEs in the studies included in our analysis. Some studies utilized structured questionnaires to assess cumulative ACEs, while others relied on self-reports focusing on specific ACEs. Several studies have used validated questionnaires to assess several ACEs. One study [ 20 ] used the Childhood Trauma Screener (CTS) [ 27 ], two studies [ 17 , 23 ] used modified versions of the Childhood Trauma Questionnaire (CTQ) [ 28 , 29 ], and two studies [ 18 , 19 ] used the Adverse Childhood Experiences International Questionnaire (ACE-IQ) [ 30 ] or a modified version of it. However, some studies have used simple questions to assess several ACEs [ 16 , 22 , 24 ] or a record to define the death of parents in childhood [ 21 ].

Cumulative scores ACE methods such as ACE-IQ and CTQ, involve summing the number of ACEs reported by each individual. Although these cumulative scores do not capture the severity of the experiences, they are widely accepted and favored in ACE research due to their greater predictive power compared to single-item scores [ 31 , 32 ]. The ACE-IQ is currently the standard tool for measuring ACEs in clinical research [ 30 ]. Accordingly, our primary analysis included studies using cumulative or composite scores, and a secondary analysis was conducted based on specific ACEs, which were reported to be significant only for child maltreatment. It is worth noting that the number and categories of ACE items varied across studies, which may be accounted for by the ACEs dose-response effect [ 33 , 34 ].

The majority of the evidence in this study comes from retrospective studies, which should be considered when interpreting the results. Retrospective studies have reported discrepancies when compared to prospective studies on ACEs [ 35 ]. In our included studies, ACE data were mostly obtained through subjective measures, such as self-reports. It is crucial to acknowledge that subjective measures of ACEs may introduce recall bias, as individuals may have difficulties remembering or may choose not to report past ACEs. Previous research has indicated a moderate correlation between subjective measures and objective measures, such as records or registries [ 36 ]. Nonetheless, this highlights the significance of the subjective nature of each child’s experience with traumatic events and its potential long-term effects.

Previous studies highlighted the possible association between ACEs and late-life cognition. Corney et al. [ 10 ]. suggested a link between ACEs and Alzheimer’s disease, although their study included only two studies and focused solely on Alzheimer’s disease. Patel et al. [ 11 ] conducted a systematic review of cross-sectional and cohort studies on the association between ACEs and late-life cognitive impairment. While their qualitative synthesis provided valuable insights, they did not explore the association between ACEs and dementia risk. In this study, we aimed to build upon previous research by conducting a quantitative synthesis with a rigorous methodology, focusing on the association between ACEs and dementia risk. Our analysis included cohort and case-control studies, incorporating six studies that were not included in the latest systematic review [ 11 ].

Strengths and limitations

Our study represents the first systematic review and MA examining the association between ACEs and the risk of late-life dementia. We adhered to the PRISMA guidelines for systematic reviews, ensuring a comprehensive and rigorous approach. The strengths of our study include the use of a robust methodology: we implemented strict inclusion and exclusion criteria to focus specifically on ACEs and dementia risk. We utilized the adjusted Newcastle–Ottawa Scale and GRADE criteria to assess the quality of the evidence. However, it is important to acknowledge the potential for human bias at any stage of the study.

This MA has certain limitations that should be acknowledged. First, the retrospective observational study designs utilized in the included studies did not establish causal relationships but rather indicated associations. However, given the nature of our study, this design was the most practical and suitable approach. Second, the number of included studies and the number of events may limit the generalizability of our results. Third, the incorporation of different measurement tools for ACEs and dementia may have introduced heterogeneity. However, we addressed this by employing a random-effects model in our MA and specifically included studies that utilized composite scores for ACEs in our primary analysis. Additionally, we conducted a subgroup analysis to explore different potential sources of heterogeneity. Fourth, the quality of evidence assessed using the GRADE approach was determined to be very low for all outcomes, underscoring the importance of additional high-quality studies to strengthen the overall evidence base. Fifth, the grey literature was not thoroughly explored which may increase the possibility of publication bias. Last, it is worth noting that our study included only publications in English, which may have resulted in the exclusion of relevant studies published in other languages.

Recommendations for future studies

Future studies should consider (1) conducting larger high-quality controlled case‒controls or retrospective cohort studies; (2) using validated cumulative ACEs score measurement tools such as the Adverse Childhood Experiences International Questionnaire and reporting data on specific adversities whenever applicable; (3) incorporating both subjective and objective ACE measurements to overcome reporting bias; (4) preferring the use of diagnostic criteria for dementia over screening tools for identifying dementia cases; and (5) including diverse representative populations from different races, education, and socioeconomic statuses.

In conclusion, the findings of this systematic review and meta-analysis suggest that ACEs may be associated with an increased risk of dementia in elderly adults. However, it is important to exercise caution when interpreting these results due to the limited number of studies and the very low quality of evidence provided by the grading system. These findings underscore the importance of recognizing early-life adversities in assessing dementia risk. However, additional high-quality longitudinal studies are needed to support our findings. ACEs have already been linked to many negative health and developmental outcomes. Understanding the association between ACEs and dementia risk has crucial clinical implications. Healthcare professionals should be attentive to children with a history of ACEs and should implement early interventions and support systems to mitigate the long-term consequences for cognitive health. Tailored strategies for individuals with specific adversities or diagnosed through certain criteria may enhance preventive measures.

To our knowledge, this is the first attempt to quantify and analyze studies on the association between ACEs and dementia risk.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request. Guarantor: Moaz Elsayed

Abbreviations

Adverse Childhood experiences

Mild Cognitive Impairment

Hazard ratio

Newcastle-Ottawa Quality Assessment Scale

confidence interval

Meta-Analysis

Stressful Life experiences

International Classification of Diseases

The Mini-Mental State Examination

Montreal Cognitive Assessment

Community Screening Interview for Dementia

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Open access funding provided by The Science, Technology & Innovation Funding Authority (STDF) in cooperation with The Egyptian Knowledge Bank (EKB).

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Amr Elrosasy and Hatem Abdelmoneim Eldeeb contributed equally to this work.

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Faculty of Medicine, Cairo University, Cairo, Egypt

Moaz Elsayed Abouelmagd & Amr Elrosasy

Faculty of Medicine, Alexandria University, Alexandria, Egypt

Maickel AbdelMeseh

Faculty of Medicine, Alazhar University, Cairo, Egypt

Hatem Abdelmoneim Eldeeb

Faculty of Medicine, Zagazig University, Zagazig, Egypt

Yehia Nabil

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Study Conceptualization and design: Moaz Elsayed. Protocol design: Moaz Elsayed, Amr Elrosasy. Abstract screening on Rayyan, Full-text screening, and study selection: Maickel AbdelMeseh, Yehia Nabil, Moaz Elsayed. Data extraction, and Quality assessment: All authors. Data analysis: Amr Elrosasy. Writing: Moaz Elsayed , Maickel AbdelMeseh, , Amr Elrosasy, Hatem Abdelmoneim Eldeeb. Figures and Tables: Moaz Elsayed, Hatem Abdelmoneim Eldeeb, Yehia Nabil, . Proofreading and Revision: Moaz Elsayed, Maickel AbdelMeseh, , Amr Elrosasy.

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Abouelmagd, M.E., AbdelMeseh, M., Elrosasy, A. et al. Adverse childhood experiences and risk of late-life dementia: a systematic review and meta-analysis. Soc Psychiatry Psychiatr Epidemiol (2024). https://doi.org/10.1007/s00127-024-02676-4

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Student 3-D Model Wows Excavator of Mysterious Ancient Egyptian Ship

Hunter Omerzo '24's 1/30-scale replica helps answer age-old questions about a famed fifth-century B.C. vessel. Photo by Dan Loh.

Shipwreck research makes waves at Oxford

by MaryAlice Bitts-Jackson

In the fifth century B.C., Herodotus described a riverboat so peculiar it sparked centuries of scholarly debate. The Greek historian called it a baris, and for ages no one could verify that his account was accurate or even true. That is, not until “Ship 17” blew Herodotus’ doubters right out of the water and made international news.

Now, Hunter Omerzo ’24 adds to the world’s understanding of it, as he has created the most detailed and accurate 3-D model of a baris to date. His recreation of Ship 17, sparked by a classroom assignment and created with his own 3-D printer, helps answer researchers’ questions. And soon, he’ll continue his research at Oxford University.

The case for 3-D

Omerzo, an Ohio native, is a Dickinson student-athlete, a double major in archaeology and classical studies  and the recipient of Raven's Claw and C.V. Starr scholarships. He learned about the baris while translating Herodotus’ writings for a class taught by Associate Professor of Classical Studies  Scott Farrington .

Omerzo painstakingly replicated each part of Ship 17 for his model. Photo by Dan Loh.

Having already dived to and learned about shipwrecks through a field-school experience, Omerzo knew that physical, 3-D models are less common in marine archaeology than their digital counterparts. And while reading about the excavation of Ship 17 in the Nile Delta, he discovered that the only 3-D baris model in existence was a rough estimation, created for a BBC documentary. Omerzo wondered if a more accurate 3-D model would help researchers better understand this mysterious ship.

“It’s sort of like how reverse engineering works,” explains Omerzo. “You can’t always tell what a certain part is for until you try to put it back together."

Expert on board!

For precise measurements, Omerzo went straight to the source. He emailed Alexander Belov, a researcher for the European Institute of Underwater Archaeology (France), which excavated Ship 17. Belov's book on the Ship 17 findings, published by the Oxford Centre for Maritime Archaeology, was Omerzo’s primary resource. 

“Hunter set the first baris afloat since the time of Herodotus. This is a great achievement." —Alexander Belov

The expert was impressed. “I got an image of Hunter as a very keen and motivated person with a great working capacity," says Belov, who not only sent his data but also remained in touch, answering questions and offering advice. "Not every person would be so intrigued by the ancient description of a vessel and undertake such a complicated and time-consuming project.”

Complex and color-coded

Slowly and carefully, Omerzo replicated each part of Ship 17 for his 1/30-scale model, down to the tiny tendons, and weighted each section to scale. He counted 837 parts, not including pegs.

Omerzo put his 3-D-printed model to the test in Dickinson's pool. Photo provided by Hunter Omerzo.

It took weeks to create the pieces with his own 3-D printer and months to assemble the model. His first attempt was a partial recreation. His second was complete, with color-coding to differentiate surviving sections of Ship 17 from missing, damaged and obscured sections. 

And then it was time to test the model in the pool.

To simulate a cargo load, Omerzo filled plastic bags with .25 kilogram of sand and added them to his mini-baris. While a thin coat of liquid rubber hadn’t waterproofed the model completely, it still floated well.

“Hunter set the first baris afloat since the time of Herodotus,” says Belov, who shared Omerzo’s findings with the marine archaeology department at Oxford University. "This is a great achievement."

But what does it mean?

Omerzo’s project provides new details about several aspects of the baris—most significantly, it shows that the design was sound. By Herodotus’ description, the baris had no frame. Instead, a single plank served as its hull, with thin, side-to-side ribs inserted into the hull planking. That skeleton-like structure provided enough support for Omerzo’s model to carry 4 kilograms of cargo.

“That was impressive, and it translated to 108 metric tons—just barely shy of Belov’s 112-metric-ton estimate,” Omerzo says. “I also got to observe how the ship sank, which is important to my current research.”

More mysteries ahead!

The end of this story marks a new beginning: Omerzo will continue his research as a master’s candidate at Oxford University. He looks forward to refining his model—this time with access to the original artifact.

Belov looks forward to learning about Omerzo’s progress. He also hopes to one day connect with Omerzo at Thonis Heracleion, the sunken city in Egypt where Ship 17 was discovered along with some 125 ancient hulls.

“It’s the greatest known cemetery of ancient ships in the world,” Belov says, “and I hope that Hunter will be able to join our excavations, because there are still so many mysteries to solve.”

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Published May 3, 2024

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