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• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, 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 analyze the case, other interesting articles.

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

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

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.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

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

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

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.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

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

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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 analyze 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.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

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What Is a Case Study? How to Write, Examples, and Template

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How to write a case study

Case study template, case study examples, types of case studies, what are the benefits of case studies , what are the limitations of case studies , case study vs. testimonial.

In today's marketplace, conveying your product's value through a compelling narrative is crucial to genuinely connecting with your customers.

Your business can use marketing analytics tools to understand what customers want to know about your product. Once you have this information, the next step is to showcase your product and its benefits to your target audience. This strategy involves a mix of data, analysis, and storytelling. Combining these elements allows you to create a narrative that engages your audience. So, how can you do this effectively?

What is a case study? 

A case study is a powerful tool for showcasing a business's success in helping clients achieve their goals. It's a form of storytelling that details real-world scenarios where a business implemented its solutions to deliver positive results for a client.

In this article, we explore the concept of a case study , including its writing process, benefits, various types, challenges, and more.

Understanding how to write a case study is an invaluable skill. You'll need to embrace decision-making – from deciding which customers to feature to designing the best format to make them as engaging as possible.  This can feel overwhelming in a hurry, so let's break it down.

Step 1: Reach out to the target persona

If you've been in business for a while, you have no shortage of happy customers. But w ith limited time and resources, you can't choose everyone.  So, take some time beforehand to flesh out your target buyer personas. 

Once you know precisely who you're targeting, go through your stable of happy customers to find a buyer representative of the audience you're trying to reach. The closer their problems, goals, and industries align, the more your case study will resonate.

What if you have more than one buyer persona? No problem. This is a common situation for companies because buyers comprise an entire committee. You might be marketing to procurement experts, executives, engineers, etc. Try to develop a case study tailored to each key persona. This might be a long-term goal, and that's fine. The better you can personalize the experience for each stakeholder, the easier it is to keep their attention.  

Here are a few considerations to think about before research:

• Products/services of yours the customer uses (and how familiar they are with them)
• The customer's brand recognition in the industry
• Whether the results they've achieved are specific and remarkable
• Whether they've switched from a competitor's product/service
• How closely aligned they are with your target audience

These items are just a jumping-off point as you develop your criteria.  Once you have a list, run each customer through it to determine your top targets. Approach the ones on the top (your "dream" case study subjects) and work your way down as needed.

Who to interview

You should consider interviewing top-level managers or executives because those are high-profile positions. But consider how close they are to your product and its results.

Focusing on an office manager or engineer who uses your product daily would be better. Look for someone with a courtside view of the effects.

The ways to request customer participation in case studies can vary, but certain principles can improve your chances:

• Make it easy for customers to work with you, respecting their valuable time. Be well-prepared and minimize their involvement.
• Emphasize how customers will benefit through increased publicity, revenue opportunities, or recognition for their success. 
• Acknowledge their contributions and showcase their achievements.
• Standardizing the request process with a script incorporating these principles can help your team consistently secure case study approvals and track performance.

Step 2: Prepare for the interview

Case study interviews are like school exams. The more prepared you are for them, the better they turn out. Preparing thoroughly also shows participants that you value their time. You don't waste precious minutes rehashing things you should have already known. You focus on getting the information you need as efficiently as possible.

You can conduct your case study interview in multiple formats, from exchanging emails to in-person interviews. This isn't a trivial decision.  As you'll see in the chart below, each format has its unique advantages and disadvantages. 

You'll also have to consider who will ask and answer the questions during your case study interview. It's wise to consider this while considering the case study format.  The number of participants factors into which format will work best. Pulling off an in-person interview becomes much harder if you're trying to juggle four or five people's busy schedules. Try a video conference instead.

Before interviewing your case study participant, it is crucial to identify the specific questions that need to be asked.  It's essential to thoroughly evaluate your collaboration with the client and understand how your product's contributions impact the company. 

Remember that structuring your case study is akin to crafting a compelling narrative. To achieve this, follow a structured approach:

• Beginning of your story. Delve into the customer's challenge that ultimately led them to do business with you. What were their problems like? What drove them to make a decision finally? Why did they choose you?
• The middle of the case study.  Your audience also wants to know about the experience of working with you. Your customer has taken action to address their problems. What happened once you got on board?
• An ending that makes you the hero.  Describe the specific results your company produced for the customer. How has the customer's business (and life) changed once they implemented your solution?

Sample questions for the case study interview

If you're preparing for a case study interview, here are some sample case study research questions to help you get started:

• What challenges led you to seek a solution?
• When did you realize the need for immediate action? Was there a tipping point?
• How did you decide on the criteria for choosing a B2B solution, and who was involved?
• What set our product or service apart from others you considered?
• How was your experience working with us post-purchase?
• Were there any pleasant surprises or exceeded expectations during our collaboration?
• How smoothly did your team integrate our solution into their workflows?
• How long before you started seeing positive results?
• How have you benefited from our products or services?
• How do you measure the value our product or service provides?

Step 3: Conduct the interview

Preparing for case study interviews can be different from everyday conversations. Here are some tips to keep in mind:

• Create a comfortable atmosphere.  Before diving into the discussion, talk about their business and personal interests. Ensure everyone is at ease, and address any questions or concerns.
• Prioritize key questions.  Lead with your most crucial questions to respect your customer's time. Interview lengths can vary, so starting with the essentials ensures you get the vital information.
• Be flexible.  Case study interviews don't have to be rigid. If your interviewee goes "off script," embrace it. Their spontaneous responses often provide valuable insights.
• Record the interview.  If not conducted via email, ask for permission to record the interview. This lets you focus on the conversation and capture valuable quotes without distractions.

Step 4: Figure out who will create the case study

When creating written case studies for your business, deciding who should handle the writing depends on cost, perspective, and revisions.

Outsourcing might be pricier, but it ensures a professionally crafted outcome. On the other hand, in-house writing has its considerations, including understanding your customers and products. 

Technical expertise and equipment are needed for video case studies, which often leads companies to consider outsourcing due to production and editing costs. 

Tip: When outsourcing work, it's essential to clearly understand pricing details to avoid surprises and unexpected charges during payment.

Step 5: Utilize storytelling

Understanding and applying storytelling elements can make your case studies unforgettable, offering a competitive edge. 

Source: The Framework Bank

Every great study follows a narrative arc (also called a "story arc"). This arc represents how a character faces challenges, struggles against raising stakes, and encounters a formidable obstacle before the tension resolves.

In a case study narrative, consider:

• Exposition. Provide background information about the company, revealing their "old life" before becoming your customer.
• Inciting incident. Highlight the problem that drove the customer to seek a solution, creating a sense of urgency.
• Obstacles (rising action). Describe the customer's journey in researching and evaluating solutions, building tension as they explore options.
• Midpoint. Explain what made the business choose your product or service and what set you apart.
• Climax. Showcase the success achieved with your product.
• Denouement. Describe the customer's transformed business and end with a call-to-action for the reader to take the next step.

Step 6: Design the case study

The adage "Don't judge a book by its cover" is familiar, but people tend to do just that quite often!

A poor layout can deter readers even if you have an outstanding case study. To create an engaging case study, follow these steps:

• Craft a compelling title. Just like you wouldn't read a newspaper article without an eye-catching headline, the same goes for case studies. Start with a title that grabs attention.
• Organize your content. Break down your content into different sections, such as challenges, results, etc. Each section can also include subsections. This case study approach divides the content into manageable portions, preventing readers from feeling overwhelmed by lengthy blocks of text.
• Conciseness is key. Keep your case study as concise as possible. The most compelling case studies are precisely long enough to introduce the customer's challenge, experience with your solution, and outstanding results. Prioritize clarity and omit any sections that may detract from the main storyline.
• Utilize visual elements. To break up text and maintain reader interest, incorporate visual elements like callout boxes, bulleted lists, and sidebars.
• Include charts and images. Summarize results and simplify complex topics by including pictures and charts. Visual aids enhance the overall appeal of your case study.
• Embrace white space. Avoid overwhelming walls of text to prevent reader fatigue. Opt for plenty of white space, use shorter paragraphs, and employ subsections to ensure easy readability and navigation.
• Enhance video case studies. In video case studies, elements like music, fonts, and color grading are pivotal in setting the right tone. Choose music that complements your message and use it strategically throughout your story. Carefully select fonts to convey the desired style, and consider how lighting and color grading can influence the mood. These elements collectively help create the desired tone for your video case study.

Step 7: Edits and revisions

Once you've finished the interview and created your case study, the hardest part is over. Now's the time for editing and revision. This might feel frustrating for impatient B2B marketers, but it can turn good stories into great ones.

Ideally, you'll want to submit your case study through two different rounds of editing and revisions:

• Internal review. Seek feedback from various team members to ensure your case study is captivating and error-free. Gather perspectives from marketing, sales, and those in close contact with customers for well-rounded insights. Use patterns from this feedback to guide revisions and apply lessons to future case studies.
• Customer feedback. Share the case study with customers to make them feel valued and ensure accuracy. Let them review quotes and data points, as they are the "heroes" of the story, and their logos will be prominently featured. This step maintains positive customer relationships.

Case study mistakes to avoid

• Ensure easy access to case studies on your website.
• Spotlight the customer, not just your business.
• Tailor each case study to a specific audience.
• Avoid excessive industry jargon in your content.

Step 8: Publishing

Take a moment to proofread your case study one more time carefully. Even if you're reasonably confident you've caught all the errors, it's always a good idea to check. Your case study will be a valuable marketing tool for years, so it's worth the investment to ensure it's flawless. Once done, your case study is all set to go!

Consider sharing a copy of the completed case study with your customer as a thoughtful gesture. They'll likely appreciate it; some may want to keep it for their records. After all, your case study wouldn't have been possible without their help, and they deserve to see the final product.

Where you publish your case study depends on its role in your overall marketing strategy. If you want to reach as many people as possible with your case study, consider publishing it on your website and social media platforms. 

Tip: Some companies prefer to keep their case studies exclusive, making them available only to those who request them. This approach is often taken to control access to valuable information and to engage more deeply with potential customers who express specific interests. It can create a sense of exclusivity and encourage interested parties to engage directly with the company.

Step 9: Case study distribution

When sharing individual case studies, concentrate on reaching the audience with the most influence on purchasing decisions

Here are some common distribution channels to consider:

• Sales teams. Share case studies to enhance customer interactions, retention , and upselling among your sales and customer success teams. Keep them updated on new studies and offer easily accessible formats like PDFs or landing page links.
• Company website. Feature case studies on your website to establish authority and provide valuable information to potential buyers. Organize them by categories such as location, size, industry, challenges, and products or services used for effective presentation.
• Events. Use live events like conferences and webinars to distribute printed case study copies, showcase video case studies at trade show booths, and conclude webinars with links to your case study library. This creative approach blends personal interactions with compelling content.
• Industry journalists. Engage relevant industry journalists to gain media coverage by identifying suitable publications and journalists covering related topics. Building relationships is vital, and platforms like HARO (Help A Reporter Out) can facilitate connections, especially if your competitors have received coverage before.

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It can seem daunting to transform the information you've gathered into a cohesive narrative.  We’ve created a versatile case study template that can serve as a solid starting point for your case study.

With this template, your business can explore any solutions offered to satisfied customers, covering their background, the factors that led them to choose your services, and their outcomes.

The template boasts a straightforward design, featuring distinct sections that guide you in effectively narrating your and your customer's story. However, remember that limitless ways to showcase your business's accomplishments exist.

To assist you in this process, here's a breakdown of the recommended sections to include in a case study:

• Title.  Keep it concise. Create a brief yet engaging project title summarizing your work with your subject. Consider your title like a newspaper headline; do it well, and readers will want to learn more. 
• Subtitle . Use this section to elaborate on the achievement briefly. Make it creative and catchy to engage your audience.
• Executive summary.  Use this as an overview of the story, followed by 2-3 bullet points highlighting key success metrics.
• Challenges and objectives. This section describes the customer's challenges before adopting your product or service, along with the goals or objectives they sought to achieve.
• How product/service helped.  A paragraph explaining how your product or service addressed their problem.
• Testimonials.  Incorporate short quotes or statements from the individuals involved in the case study, sharing their perspectives and experiences.
• Supporting visuals.  Include one or two impactful visuals, such as graphs, infographics, or highlighted metrics, that reinforce the narrative.
• Call to action (CTA).  If you do your job well, your audience will read (or watch) your case studies from beginning to end. They are interested in everything you've said. Now, what's the next step they should take to continue their relationship with you? Give people a simple action they can complete. 

Case studies are proven marketing strategies in a wide variety of B2B industries. Here are just a few examples of a case study:

• Amazon Web Services, Inc.  provides companies with cloud computing platforms and APIs on a metered, pay-as-you-go basis. This case study example illustrates the benefits Thomson Reuters experienced using AWS.
• LinkedIn Marketing Solutions combines captivating visuals with measurable results in the case study created for BlackRock. This case study illustrates how LinkedIn has contributed to the growth of BlackRock's brand awareness over the years. 
• Salesforce , a sales and marketing automation SaaS solutions provider, seamlessly integrates written and visual elements to convey its success stories with Pepe Jeans. This case study effectively demonstrates how Pepe Jeans is captivating online shoppers with immersive and context-driven e-commerce experiences through Salesforce.
• HubSpot offers a combination of sales and marketing tools. Their case study demonstrates the effectiveness of its all-in-one solutions. These typically focus on a particular client's journey and how HubSpot helped them achieve significant results.

There are two different types of case studies that businesses might utilize:

Written case studies 

Written case studies offer readers a clear visual representation of data, which helps them quickly identify and focus on the information that matters most. 

Printed versions of case studies find their place at events like trade shows, where they serve as valuable sales collateral to engage prospective clients.  Even in the digital age, many businesses provide case studies in PDF format or as web-based landing pages, improving accessibility for their audience. 

Note: Landing pages , in particular, offer the flexibility to incorporate rich multimedia content, including images, charts, and videos. This flexibility in design makes landing pages an attractive choice for presenting detailed content to the audience.

Written case study advantages

Here are several significant advantages to leveraging case studies for your company:

• Hyperlink accessibility.  Whether in PDF or landing page format, written case studies allow for embedded hyperlinks, offering prospects easy access to additional information and contact forms.
• Flexible engagement.  Unlike video case studies, which may demand in-person arrangements, written case studies can be conducted via phone or video streaming, reducing customer commitment and simplifying scheduling.
• Efficient scanning . Well-structured written case studies with a scannable format cater to time-strapped professionals. Charts and callout boxes with key statistics enhance the ease of information retrieval.
• Printable for offline use.  Written case studies can be effortlessly printed and distributed at trade shows, sales meetings, and live events. This tangible format accommodates those who prefer physical materials and provides versatility in outreach, unlike video content, which is less portable.

Written case study disadvantages

Here are some drawbacks associated with the use of case studies:

• Reduced emotional impact.  Written content lacks the emotional punch of live video testimonials, which engage more senses and emotions, making a stronger connection.
• Consider time investment.  Creating a compelling case study involves editing, proofreading, and design collaboration, with multiple revisions commonly required before publication.
• Challenges in maintaining attention.  Attention spans are short in today's ad-saturated world. Using graphics, infographics, and videos more often is more powerful to incite the right emotions in customers.

Video case studies

Video case studies are the latest marketing trend. Unlike in the past, when video production was costly, today's tools make it more accessible for users to create and edit their videos. However, specific technical requirements still apply.

Like written case studies, video case studies delve into a specific customer's challenges and how your business provides solutions. Yet, the video offers a more profound connection by showcasing the person who faced and conquered the problem.

Video case studies can boost brand exposure when shared on platforms like YouTube. For example, Slack's engaging case study video with Sandwich Video illustrates how Slack transformed its workflow and adds humor, which can be challenging in written case studies focused on factual evidence.

Source : YouTube

This video case study has garnered nearly a million views on YouTube.

Video case study advantages

Here are some of the top advantages of video case studies. While video testimonials take more time, the payoff can be worth it. 

• Humanization and authenticity.  Video case studies connect viewers with real people, adding authenticity and fostering a stronger emotional connection.
• Engaging multiple senses.  They engage both auditory and visual senses, enhancing credibility and emotional impact. Charts, statistics, and images can also be incorporated.
• Broad distribution.  Videos can be shared on websites, YouTube, social media, and more, reaching diverse audiences and boosting engagement, especially on social platforms.

Video case study disadvantages

Before fully committing to video testimonials, consider the following:

• Technical expertise and equipment.  Video production requires technical know-how and equipment, which can be costly. Skilled video editing is essential to maintain a professional image. While technology advances, producing amateurish videos may harm your brand's perception.
• Viewer convenience.  Some prospects prefer written formats due to faster reading and ease of navigation. Video typically requires sound, which can be inconvenient for viewers in specific settings. Many people may not have headphones readily available to watch your content.
• Demand on case study participants.  On-camera interviews can be time-consuming and location-dependent, making scheduling challenging for case study participants. Additionally, being on screen for a global audience may create insecurities and performance pressure.
• Comfort on camera.  Not everyone feels at ease on camera. Nervousness or a different on-screen persona can impact the effectiveness of the testimonial, and discovering this late in the process can be problematic.

Written or video case studies: Which is right for you?

Now that you know the pros and cons of each, how do you choose which is right for you?

One of the most significant factors in doing video case studies can be the technical expertise and equipment required for a high level of production quality. Whether you have the budget to do this in-house or hire a production company can be one of the major deciding factors.

Still, written or video doesn't have to be an either-or decision. Some B2B companies are using both formats. They can complement each other nicely, minimizing the downsides mentioned above and reaching your potential customers where they prefer.

Let's say you're selling IT network security. What you offer is invaluable but complicated. You could create a short (three- or four-minute) video case study to get attention and touch on the significant benefits of your services. This whets the viewer's appetite for more information, which they could find in a written case study that supplements the video.

Should you decide to test the water in video case studies, test their effectiveness among your target audience. See how well they work for your company and sales team. And, just like a written case study, you can always find ways to improve your process as you continue exploring video case studies.

Case studies offer several distinctive advantages, making them an ideal tool for businesses to market their products to customers. However, their benefits extend beyond these qualities. 

Here's an overview of all the advantages of case studies:

Valuable sales support

Case studies serve as a valuable resource for your sales endeavors. Buyers frequently require additional information before finalizing a purchase decision. These studies provide concrete evidence of your product or service's effectiveness, assisting your sales representatives in closing deals more efficiently, especially with customers with lingering uncertainties.

Validating your value

Case studies serve as evidence of your product or service's worth or value proposition , playing a role in building trust with potential customers. By showcasing successful partnerships, you make it easier for prospects to place trust in your offerings. This effect is particularly notable when the featured customer holds a reputable status.

Unique and engaging content

By working closely with your customer success teams, you can uncover various customer stories that resonate with different prospects. Case studies allow marketers to shape product features and benefits into compelling narratives. 

Each case study's distinctiveness, mirroring the uniqueness of every customer's journey, makes them a valuable source of relatable and engaging content. Storytelling possesses the unique ability to connect with audiences on an emotional level, a dimension that statistics alone often cannot achieve. 

Spotlighting valuable customers

Case studies provide a valuable platform for showcasing your esteemed customers. Featuring them in these studies offers a chance to give them visibility and express your gratitude for the partnership, which can enhance customer loyalty . Depending on the company you are writing about, it can also demonstrate the caliber of your business.

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It's important to consider limitations when designing and interpreting the results of case studies. Here's an overview of the limitations of case studies:

Challenges in replication

Case studies often focus on specific individuals, organizations, or situations, making generalizing their findings to broader populations or contexts challenging. 

Time-intensive process

Case studies require a significant time investment. The extensive data collection process and the need for comprehensive analysis can be demanding, especially for researchers who are new to this method.

Potential for errors

Case studies can be influenced by memory and judgment, potentially leading to inaccuracies. Depending on human memory to reconstruct a case's history may result in variations and potential inconsistencies in how individuals recall past events. Additionally, bias may emerge, as individuals tend to prioritize what they consider most significant, which could limit their consideration of alternative perspectives.

Challenges in verification

Confirming results through additional research can present difficulties. This complexity arises from the need for detailed and extensive data in the initial creation of a case study. Consequently, this process requires significant effort and a substantial amount of time.

While looking at case studies, you may have noticed a quote. This type of quote is considered a testimonial, a key element of case studies.

If a customer's quote proves that your brand does what it says it will or performs as expected, you may wonder: 'Aren't customer testimonials and case studies the same thing?' Not exactly.

Testimonials are brief endorsements designed to establish trust on a broad scale. In contrast, case studies are detailed narratives that offer a comprehensive understanding of how a product or service addresses a specific problem, targeting a more focused audience. 

Crafting case studies requires more resources and a structured approach than testimonials. Your selection between the two depends on your marketing objectives and the complexity of your product or service.

Case in point!

Case studies are among a company's most effective tools. You're  well on your way to mastering them.

Today's buyers are tackling much of the case study research methodology independently. Many are understandably skeptical before making a buying decision. By connecting them with multiple case studies, you can prove you've gotten the results you say you can. There's hardly a better way to boost your credibility and persuade them to consider your solution.

Case study formats and distribution methods might change as technology evolves. However, the fundamentals that make them effective—knowing how to choose subjects, conduct interviews, and structure everything to get attention—will serve you for as long as you're in business. 

We covered a ton of concepts and resources, so go ahead and bookmark this page. You can refer to it whenever you have questions or need a refresher.

Dive into market research to uncover customer preferences and spending habits.

Kristen McCabe

Kristen’s is a former senior content marketing specialist at G2. Her global marketing experience extends from Australia to Chicago, with expertise in B2B and B2C industries. Specializing in content, conversions, and events, Kristen spends her time outside of work time acting, learning nature photography, and joining in the #instadog fun with her Pug/Jack Russell, Bella. (she/her/hers)

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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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Case Study Research Method in Psychology

Saul McLeod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

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Associate Editor for Simply Psychology

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On This Page:

Case studies are in-depth investigations of a person, group, event, or community. Typically, data is gathered from various sources using several methods (e.g., observations & interviews).

The case study research method originated in clinical medicine (the case history, i.e., the patient’s personal history). In psychology, case studies are often confined to the study of a particular individual.

The information is mainly biographical and relates to events in the individual’s past (i.e., retrospective), as well as to significant events that are currently occurring in his or her everyday life.

The case study is not a research method, but researchers select methods of data collection and analysis that will generate material suitable for case studies.

Freud (1909a, 1909b) conducted very detailed investigations into the private lives of his patients in an attempt to both understand and help them overcome their illnesses.

This makes it clear that the case study is a method that should only be used by a psychologist, therapist, or psychiatrist, i.e., someone with a professional qualification.

There is an ethical issue of competence. Only someone qualified to diagnose and treat a person can conduct a formal case study relating to atypical (i.e., abnormal) behavior or atypical development.

 Famous Case Studies

• Anna O – One of the most famous case studies, documenting psychoanalyst Josef Breuer’s treatment of “Anna O” (real name Bertha Pappenheim) for hysteria in the late 1800s using early psychoanalytic theory.
• Little Hans – A child psychoanalysis case study published by Sigmund Freud in 1909 analyzing his five-year-old patient Herbert Graf’s house phobia as related to the Oedipus complex.
• Bruce/Brenda – Gender identity case of the boy (Bruce) whose botched circumcision led psychologist John Money to advise gender reassignment and raise him as a girl (Brenda) in the 1960s.
• Genie Wiley – Linguistics/psychological development case of the victim of extreme isolation abuse who was studied in 1970s California for effects of early language deprivation on acquiring speech later in life.
• Phineas Gage – One of the most famous neuropsychology case studies analyzes personality changes in railroad worker Phineas Gage after an 1848 brain injury involving a tamping iron piercing his skull.

Clinical Case Studies

• Studying the effectiveness of psychotherapy approaches with an individual patient
• Assessing and treating mental illnesses like depression, anxiety disorders, PTSD
• Neuropsychological cases investigating brain injuries or disorders

Child Psychology Case Studies

• Studying psychological development from birth through adolescence
• Cases of learning disabilities, autism spectrum disorders, ADHD
• Effects of trauma, abuse, deprivation on development

Types of Case Studies

• Explanatory case studies : Used to explore causation in order to find underlying principles. Helpful for doing qualitative analysis to explain presumed causal links.
• Exploratory case studies : Used to explore situations where an intervention being evaluated has no clear set of outcomes. It helps define questions and hypotheses for future research.
• Descriptive case studies : Describe an intervention or phenomenon and the real-life context in which it occurred. It is helpful for illustrating certain topics within an evaluation.
• Multiple-case studies : Used to explore differences between cases and replicate findings across cases. Helpful for comparing and contrasting specific cases.
• Intrinsic : Used to gain a better understanding of a particular case. Helpful for capturing the complexity of a single case.
• Collective : Used to explore a general phenomenon using multiple case studies. Helpful for jointly studying a group of cases in order to inquire into the phenomenon.

Where Do You Find Data for a Case Study?

There are several places to find data for a case study. The key is to gather data from multiple sources to get a complete picture of the case and corroborate facts or findings through triangulation of evidence. Most of this information is likely qualitative (i.e., verbal description rather than measurement), but the psychologist might also collect numerical data.

1. Primary sources

• Interviews – Interviewing key people related to the case to get their perspectives and insights. The interview is an extremely effective procedure for obtaining information about an individual, and it may be used to collect comments from the person’s friends, parents, employer, workmates, and others who have a good knowledge of the person, as well as to obtain facts from the person him or herself.
• Observations – Observing behaviors, interactions, processes, etc., related to the case as they unfold in real-time.
• Documents & Records – Reviewing private documents, diaries, public records, correspondence, meeting minutes, etc., relevant to the case.

2. Secondary sources

• News/Media – News coverage of events related to the case study.
• Academic articles – Journal articles, dissertations etc. that discuss the case.
• Government reports – Official data and records related to the case context.
• Books/films – Books, documentaries or films discussing the case.

3. Archival records

Searching historical archives, museum collections and databases to find relevant documents, visual/audio records related to the case history and context.

Public archives like newspapers, organizational records, photographic collections could all include potentially relevant pieces of information to shed light on attitudes, cultural perspectives, common practices and historical contexts related to psychology.

4. Organizational records

Organizational records offer the advantage of often having large datasets collected over time that can reveal or confirm psychological insights.

Of course, privacy and ethical concerns regarding confidential data must be navigated carefully.

However, with proper protocols, organizational records can provide invaluable context and empirical depth to qualitative case studies exploring the intersection of psychology and organizations.

• Organizational/industrial psychology research : Organizational records like employee surveys, turnover/retention data, policies, incident reports etc. may provide insight into topics like job satisfaction, workplace culture and dynamics, leadership issues, employee behaviors etc.
• Clinical psychology : Therapists/hospitals may grant access to anonymized medical records to study aspects like assessments, diagnoses, treatment plans etc. This could shed light on clinical practices.
• School psychology : Studies could utilize anonymized student records like test scores, grades, disciplinary issues, and counseling referrals to study child development, learning barriers, effectiveness of support programs, and more.

How do I Write a Case Study in Psychology?

Follow specified case study guidelines provided by a journal or your psychology tutor. General components of clinical case studies include: background, symptoms, assessments, diagnosis, treatment, and outcomes. Interpreting the information means the researcher decides what to include or leave out. A good case study should always clarify which information is the factual description and which is an inference or the researcher’s opinion.

1. Introduction

• Provide background on the case context and why it is of interest, presenting background information like demographics, relevant history, and presenting problem.
• Compare briefly to similar published cases if applicable. Clearly state the focus/importance of the case.

2. Case Presentation

• Describe the presenting problem in detail, including symptoms, duration,and impact on daily life.
• Include client demographics like age and gender, information about social relationships, and mental health history.
• Describe all physical, emotional, and/or sensory symptoms reported by the client.
• Use patient quotes to describe the initial complaint verbatim. Follow with full-sentence summaries of relevant history details gathered, including key components that led to a working diagnosis.
• Summarize clinical exam results, namely orthopedic/neurological tests, imaging, lab tests, etc. Note actual results rather than subjective conclusions. Provide images if clearly reproducible/anonymized.
• Clearly state the working diagnosis or clinical impression before transitioning to management.

3. Management and Outcome

• Indicate the total duration of care and number of treatments given over what timeframe. Use specific names/descriptions for any therapies/interventions applied.
• Present the results of the intervention,including any quantitative or qualitative data collected.
• For outcomes, utilize visual analog scales for pain, medication usage logs, etc., if possible. Include patient self-reports of improvement/worsening of symptoms. Note the reason for discharge/end of care.

4. Discussion

• Analyze the case, exploring contributing factors, limitations of the study, and connections to existing research.
• Analyze the effectiveness of the intervention,considering factors like participant adherence, limitations of the study, and potential alternative explanations for the results.
• Identify any questions raised in the case analysis and relate insights to established theories and current research if applicable. Avoid definitive claims about physiological explanations.
• Offer clinical implications, and suggest future research directions.

5. Additional Items

• Thank specific assistants for writing support only. No patient acknowledgments.
• References should directly support any key claims or quotes included.
• Use tables/figures/images only if substantially informative. Include permissions and legends/explanatory notes.
• Provides detailed (rich qualitative) information.
• Provides insight for further research.
• Permitting investigation of otherwise impractical (or unethical) situations.

Case studies allow a researcher to investigate a topic in far more detail than might be possible if they were trying to deal with a large number of research participants (nomothetic approach) with the aim of ‘averaging’.

Because of their in-depth, multi-sided approach, case studies often shed light on aspects of human thinking and behavior that would be unethical or impractical to study in other ways.

Research that only looks into the measurable aspects of human behavior is not likely to give us insights into the subjective dimension of experience, which is important to psychoanalytic and humanistic psychologists.

Case studies are often used in exploratory research. They can help us generate new ideas (that might be tested by other methods). They are an important way of illustrating theories and can help show how different aspects of a person’s life are related to each other.

The method is, therefore, important for psychologists who adopt a holistic point of view (i.e., humanistic psychologists ).

Limitations

• Lacking scientific rigor and providing little basis for generalization of results to the wider population.
• Researchers’ own subjective feelings may influence the case study (researcher bias).
• Difficult to replicate.
• Time-consuming and expensive.
• The volume of data, together with the time restrictions in place, impacted the depth of analysis that was possible within the available resources.

Because a case study deals with only one person/event/group, we can never be sure if the case study investigated is representative of the wider body of “similar” instances. This means the conclusions drawn from a particular case may not be transferable to other settings.

Because case studies are based on the analysis of qualitative (i.e., descriptive) data , a lot depends on the psychologist’s interpretation of the information she has acquired.

This means that there is a lot of scope for Anna O , and it could be that the subjective opinions of the psychologist intrude in the assessment of what the data means.

For example, Freud has been criticized for producing case studies in which the information was sometimes distorted to fit particular behavioral theories (e.g., Little Hans ).

This is also true of Money’s interpretation of the Bruce/Brenda case study (Diamond, 1997) when he ignored evidence that went against his theory.

Breuer, J., & Freud, S. (1895).  Studies on hysteria . Standard Edition 2: London.

Curtiss, S. (1981). Genie: The case of a modern wild child .

Diamond, M., & Sigmundson, K. (1997). Sex Reassignment at Birth: Long-term Review and Clinical Implications. Archives of Pediatrics & Adolescent Medicine , 151(3), 298-304

Freud, S. (1909a). Analysis of a phobia of a five year old boy. In The Pelican Freud Library (1977), Vol 8, Case Histories 1, pages 169-306

Freud, S. (1909b). Bemerkungen über einen Fall von Zwangsneurose (Der “Rattenmann”). Jb. psychoanal. psychopathol. Forsch ., I, p. 357-421; GW, VII, p. 379-463; Notes upon a case of obsessional neurosis, SE , 10: 151-318.

Harlow J. M. (1848). Passage of an iron rod through the head.  Boston Medical and Surgical Journal, 39 , 389–393.

Harlow, J. M. (1868).  Recovery from the Passage of an Iron Bar through the Head .  Publications of the Massachusetts Medical Society. 2  (3), 327-347.

Money, J., & Ehrhardt, A. A. (1972).  Man & Woman, Boy & Girl : The Differentiation and Dimorphism of Gender Identity from Conception to Maturity. Baltimore, Maryland: Johns Hopkins University Press.

Money, J., & Tucker, P. (1975). Sexual signatures: On being a man or a woman.

Further Information

• Case Study Approach
• Case Study Method
• Enhancing the Quality of Case Studies in Health Services Research
• “We do things together” A case study of “couplehood” in dementia
• Using mixed methods for evaluating an integrative approach to cancer care: a case study

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What Is a Case Study?

Weighing the pros and cons of this method of research

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."

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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What is a Case Study in Research? Definition, Methods, and Examples

Case study methodology offers researchers an exciting opportunity to explore intricate phenomena within specific contexts using a wide range of data sources and collection methods. It is highly pertinent in health and social sciences, environmental studies, social work, education, and business studies. Its diverse applications, such as advancing theory, program evaluation, and intervention development, make it an invaluable tool for driving meaningful research and fostering positive change.[ 1]  

Table of Contents

What is a Case Study?  

A case study method involves a detailed examination of a single subject, such as an individual, group, organization, event, or community, to explore and understand complex issues in real-life contexts. By focusing on one specific case, researchers can gain a deep understanding of the factors and dynamics at play, understanding their complex relationships, which might be missed in broader, more quantitative studies.  

When to do a Case Study?  

A case study design is useful when you want to explore a phenomenon in-depth and in its natural context. Here are some examples of when to use a case study :[ 2]  

• Exploratory Research: When you want to explore a new topic or phenomenon, a case study can help you understand the subject deeply. For example , a researcher studying a newly discovered plant species might use a case study to document its characteristics and behavior.  
• Descriptive Research: If you want to describe a complex phenomenon or process, a case study can provide a detailed and comprehensive description. For instance, a case study design   could describe the experiences of a group of individuals living with a rare disease.  
• Explanatory Research: When you want to understand why a particular phenomenon occurs, a case study can help you identify causal relationships. A case study design could investigate the reasons behind the success or failure of a particular business strategy.  
• Theory Building: Case studies can also be used to develop or refine theories. By systematically analyzing a series of cases, researchers can identify patterns and relationships that can contribute to developing new theories or refining existing ones.  
• Critical Instance: Sometimes, a single case can be used to study a rare or unusual phenomenon, but it is important for theoretical or practical reasons. For example , the case of Phineas Gage, a man who survived a severe brain injury, has been widely studied to understand the relationship between the brain and behavior.  
• Comparative Analysis: Case studies can also compare different cases or contexts. A case study example involves comparing the implementation of a particular policy in different countries to understand its effectiveness and identifying best practices.  

How to Create a Case Study – Step by Step  

Step 1: select a case  .

Careful case selection ensures relevance, insight, and meaningful contribution to existing knowledge in your field. Here’s how you can choose a case study design :[ 3]  

• Define Your Objectives: Clarify the purpose of your case study and what you hope to achieve. Do you want to provide new insights, challenge existing theories, propose solutions to a problem, or explore new research directions?  
• Consider Unusual or Outlying Cases: Focus on unusual, neglected, or outlying cases that can provide unique insights.  
• Choose a Representative Case: Alternatively, select a common or representative case to exemplify a particular category, experience, or phenomenon.   
• Avoid Bias: Ensure your selection process is unbiased using random or criteria-based selection.  
• Be Clear and Specific: Clearly define the boundaries of your study design , including the scope, timeframe, and key stakeholders.   
• Ethical Considerations: Consider ethical issues, such as confidentiality and informed consent.  

Step 2: Build a Theoretical Framework  

To ensure your case study has a solid academic foundation, it’s important to build a theoretical framework:   

• Conduct a Literature Review: Identify key concepts and theories relevant to your case study .  
• Establish Connections with Theory: Connect your case study with existing theories in the field.  
• Guide Your Analysis and Interpretation: Use your theoretical framework to guide your analysis, ensuring your findings are grounded in established theories and concepts.   

Step 3: Collect Your Data  

To conduct a comprehensive case study , you can use various research methods. These include interviews, observations, primary and secondary sources analysis, surveys, and a mixed methods approach. The aim is to gather rich and diverse data to enable a detailed analysis of your case study .  

Step 4: Describe and Analyze the Case  

How you report your findings will depend on the type of research you’re conducting. Here are two approaches:   

• Structured Approach: Follows a scientific paper format, making it easier for readers to follow your argument.  
• Narrative Approach: A more exploratory style aiming to analyze meanings and implications.  

Regardless of the approach you choose, it’s important to include the following elements in your case study :   

• Contextual Details: Provide background information about the case, including relevant historical, cultural, and social factors that may have influenced the outcome.  
• Literature and Theory: Connect your case study to existing literature and theory in the field. Discuss how your findings contribute to or challenge existing knowledge.  
• Wider Patterns or Debates: Consider how your case study fits into wider patterns or debates within the field. Discuss any implications your findings may have for future research or practice.  

What Are the Benefits of a Case Study   

Case studies offer a range of benefits , making them a powerful tool in research.  

1. In-Depth Analysis  

• Comprehensive Understanding: Case studies allow researchers to thoroughly explore a subject, understanding the complexities and nuances involved.  
• Rich Data: They offer rich qualitative and sometimes quantitative data, capturing the intricacies of real-life contexts.  

2. Contextual Insight  

• Real-World Application: Case studies provide insights into real-world applications, making the findings highly relevant and practical.  
• Context-Specific: They highlight how various factors interact within a specific context, offering a detailed picture of the situation.  

3. Flexibility  

• Methodological Diversity: Case studies can use various data collection methods, including interviews, observations, document analysis, and surveys.  
• Adaptability: Researchers can adapt the case study approach to fit the specific needs and circumstances of the research.  

4. Practical Solutions  

• Actionable Insights: The detailed findings from case studies can inform practical solutions and recommendations for practitioners and policymakers.  
• Problem-Solving: They help understand the root causes of problems and devise effective strategies to address them.  

5. Unique Cases  

• Rare Phenomena: Case studies are particularly valuable for studying rare or unique cases that other research methods may not capture.  
• Detailed Documentation: They document and preserve detailed information about specific instances that might otherwise be overlooked.  

What Are the Limitations of a Case Study   

While case studies offer valuable insights and a detailed understanding of complex issues, they have several limitations .  

1. Limited Generalizability  

• Specific Context: Case studies often focus on a single case or a small number of cases, which may limit the generalization of findings to broader populations or different contexts.  
• Unique Situations: The unique characteristics of the case may not be representative of other situations, reducing the applicability of the results.  

2. Subjectivity  

• Researcher Bias: The researcher’s perspectives and interpretations can influence the analysis and conclusions, potentially introducing bias.  
• Participant Bias: Participants’ responses and behaviors may be influenced by their awareness of being studied, known as the Hawthorne effect.  

3. Time-Consuming  

• Data Collection and Analysis: Gathering detailed, in-depth data requires significant time and effort, making case studies more time-consuming than other research methods.  
• Longitudinal Studies: If the case study observes changes over time, it can become even more prolonged.  

4. Resource Intensive  

• Financial and Human Resources: Conducting comprehensive case studies may require significant financial investment and human resources, including trained researchers and participant access.  
• Access to Data: Accessing relevant and reliable data sources can be challenging, particularly in sensitive or proprietary contexts.  

5. Replication Difficulties  

• Unique Contexts: A case study’s specific and detailed context makes it difficult to replicate the study exactly, limiting the ability to validate findings through repetition.  
• Variability: Differences in contexts, researchers, and methodologies can lead to variations in findings, complicating efforts to achieve consistent results.  

By acknowledging and addressing these limitations , researchers can enhance the rigor and reliability of their case study findings.  

Key Takeaways  

Case studies are valuable in research because they provide an in-depth, contextual analysis of a single subject, event, or organization. They allow researchers to explore complex issues in real-world settings, capturing detailed qualitative and quantitative data. This method is useful for generating insights, developing theories, and offering practical solutions to problems. They are versatile, applicable in diverse fields such as business, education, and health, and can complement other research methods by providing rich, contextual evidence. However, their findings may have limited generalizability due to the focus on a specific case.  

Frequently Asked Questions  

Q: What is a case study in research?  

A case study in research is an impactful tool for gaining a deep understanding of complex issues within their real-life context. It combines various data collection methods and provides rich, detailed insights that can inform theory development and practical applications.  

Q: What are the advantages of using case studies in research?  

Case studies are a powerful research method, offering advantages such as in-depth analysis, contextual insights, flexibility, rich data, and the ability to handle complex issues. They are particularly valuable for exploring new areas, generating hypotheses, and providing detailed, illustrative examples that can inform theory and practice.  

Q: Can case studies be used in quantitative research?  

While case studies are predominantly associated with qualitative research, they can effectively incorporate quantitative methods to provide a more comprehensive analysis. A mixed-methods approach leverages qualitative and quantitative research strengths, offering a powerful tool for exploring complex issues in a real-world context. For example , a new medical treatment case study can incorporate quantitative clinical outcomes (e.g., patient recovery rates and dosage levels) along with qualitative patient interviews.  

Q: What are the key components of a case study?  

A case study typically includes several key components:   

• Introductio n, which provides an overview and sets the context by presenting the problem statement and research objectives;  
• Literature review , which connects the study to existing theories and prior research;  
• Methodology , which details the case study design , data collection methods, and analysis techniques;   
• Findings , which present the data and results, including descriptions, patterns, and themes;   
• Discussion and conclusion , which interpret the findings, discuss their implications, and offer conclusions, practical applications, limitations, and suggestions for future research.  

Together, these components ensure a comprehensive, systematic, and insightful exploration of the case.  

References  

• de Vries, K. (2020). Case study methodology. In  Critical qualitative health research  (pp. 41-52). Routledge.  
• Fidel, R. (1984). The case study method: A case study.  Library and Information Science Research ,  6 (3), 273-288.  
• Thomas, G. (2021). How to do your case study.  How to do your case study , 1-320.  

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Continuing to enhance the quality of case study methodology in health services research

Shannon l. sibbald.

1 Faculty of Health Sciences, Western University, London, Ontario, Canada.

2 Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

3 The Schulich Interfaculty Program in Public Health, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.

Stefan Paciocco

Meghan fournie, rachelle van asseldonk, tiffany scurr.

Case study methodology has grown in popularity within Health Services Research (HSR). However, its use and merit as a methodology are frequently criticized due to its flexible approach and inconsistent application. Nevertheless, case study methodology is well suited to HSR because it can track and examine complex relationships, contexts, and systems as they evolve. Applied appropriately, it can help generate information on how multiple forms of knowledge come together to inform decision-making within healthcare contexts. In this article, we aim to demystify case study methodology by outlining its philosophical underpinnings and three foundational approaches. We provide literature-based guidance to decision-makers, policy-makers, and health leaders on how to engage in and critically appraise case study design. We advocate that researchers work in collaboration with health leaders to detail their research process with an aim of strengthening the validity and integrity of case study for its continued and advanced use in HSR.

Introduction

The popularity of case study research methodology in Health Services Research (HSR) has grown over the past 40 years. 1 This may be attributed to a shift towards the use of implementation research and a newfound appreciation of contextual factors affecting the uptake of evidence-based interventions within diverse settings. 2 Incorporating context-specific information on the delivery and implementation of programs can increase the likelihood of success. 3 , 4 Case study methodology is particularly well suited for implementation research in health services because it can provide insight into the nuances of diverse contexts. 5 , 6 In 1999, Yin 7 published a paper on how to enhance the quality of case study in HSR, which was foundational for the emergence of case study in this field. Yin 7 maintains case study is an appropriate methodology in HSR because health systems are constantly evolving, and the multiple affiliations and diverse motivations are difficult to track and understand with traditional linear methodologies.

Despite its increased popularity, there is debate whether a case study is a methodology (ie, a principle or process that guides research) or a method (ie, a tool to answer research questions). Some criticize case study for its high level of flexibility, perceiving it as less rigorous, and maintain that it generates inadequate results. 8 Others have noted issues with quality and consistency in how case studies are conducted and reported. 9 Reporting is often varied and inconsistent, using a mix of approaches such as case reports, case findings, and/or case study. Authors sometimes use incongruent methods of data collection and analysis or use the case study as a default when other methodologies do not fit. 9 , 10 Despite these criticisms, case study methodology is becoming more common as a viable approach for HSR. 11 An abundance of articles and textbooks are available to guide researchers through case study research, including field-specific resources for business, 12 , 13 nursing, 14 and family medicine. 15 However, there remains confusion and a lack of clarity on the key tenets of case study methodology.

Several common philosophical underpinnings have contributed to the development of case study research 1 which has led to different approaches to planning, data collection, and analysis. This presents challenges in assessing quality and rigour for researchers conducting case studies and stakeholders reading results.

This article discusses the various approaches and philosophical underpinnings to case study methodology. Our goal is to explain it in a way that provides guidance for decision-makers, policy-makers, and health leaders on how to understand, critically appraise, and engage in case study research and design, as such guidance is largely absent in the literature. This article is by no means exhaustive or authoritative. Instead, we aim to provide guidance and encourage dialogue around case study methodology, facilitating critical thinking around the variety of approaches and ways quality and rigour can be bolstered for its use within HSR.

Purpose of case study methodology

Case study methodology is often used to develop an in-depth, holistic understanding of a specific phenomenon within a specified context. 11 It focuses on studying one or multiple cases over time and uses an in-depth analysis of multiple information sources. 16 , 17 It is ideal for situations including, but not limited to, exploring under-researched and real-life phenomena, 18 especially when the contexts are complex and the researcher has little control over the phenomena. 19 , 20 Case studies can be useful when researchers want to understand how interventions are implemented in different contexts, and how context shapes the phenomenon of interest.

In addition to demonstrating coherency with the type of questions case study is suited to answer, there are four key tenets to case study methodologies: (1) be transparent in the paradigmatic and theoretical perspectives influencing study design; (2) clearly define the case and phenomenon of interest; (3) clearly define and justify the type of case study design; and (4) use multiple data collection sources and analysis methods to present the findings in ways that are consistent with the methodology and the study’s paradigmatic base. 9 , 16 The goal is to appropriately match the methods to empirical questions and issues and not to universally advocate any single approach for all problems. 21

Approaches to case study methodology

Three authors propose distinct foundational approaches to case study methodology positioned within different paradigms: Yin, 19 , 22 Stake, 5 , 23 and Merriam 24 , 25 ( Table 1 ). Yin is strongly post-positivist whereas Stake and Merriam are grounded in a constructivist paradigm. Researchers should locate their research within a paradigm that explains the philosophies guiding their research 26 and adhere to the underlying paradigmatic assumptions and key tenets of the appropriate author’s methodology. This will enhance the consistency and coherency of the methods and findings. However, researchers often do not report their paradigmatic position, nor do they adhere to one approach. 9 Although deliberately blending methodologies may be defensible and methodologically appropriate, more often it is done in an ad hoc and haphazard way, without consideration for limitations.

Cross-analysis of three case study approaches, adapted from Yazan 2015

The post-positive paradigm postulates there is one reality that can be objectively described and understood by “bracketing” oneself from the research to remove prejudice or bias. 27 Yin focuses on general explanation and prediction, emphasizing the formulation of propositions, akin to hypothesis testing. This approach is best suited for structured and objective data collection 9 , 11 and is often used for mixed-method studies.

Constructivism assumes that the phenomenon of interest is constructed and influenced by local contexts, including the interaction between researchers, individuals, and their environment. 27 It acknowledges multiple interpretations of reality 24 constructed within the context by the researcher and participants which are unlikely to be replicated, should either change. 5 , 20 Stake and Merriam’s constructivist approaches emphasize a story-like rendering of a problem and an iterative process of constructing the case study. 7 This stance values researcher reflexivity and transparency, 28 acknowledging how researchers’ experiences and disciplinary lenses influence their assumptions and beliefs about the nature of the phenomenon and development of the findings.

Defining a case

A key tenet of case study methodology often underemphasized in literature is the importance of defining the case and phenomenon. Researches should clearly describe the case with sufficient detail to allow readers to fully understand the setting and context and determine applicability. Trying to answer a question that is too broad often leads to an unclear definition of the case and phenomenon. 20 Cases should therefore be bound by time and place to ensure rigor and feasibility. 6

Yin 22 defines a case as “a contemporary phenomenon within its real-life context,” (p13) which may contain a single unit of analysis, including individuals, programs, corporations, or clinics 29 (holistic), or be broken into sub-units of analysis, such as projects, meetings, roles, or locations within the case (embedded). 30 Merriam 24 and Stake 5 similarly define a case as a single unit studied within a bounded system. Stake 5 , 23 suggests bounding cases by contexts and experiences where the phenomenon of interest can be a program, process, or experience. However, the line between the case and phenomenon can become muddy. For guidance, Stake 5 , 23 describes the case as the noun or entity and the phenomenon of interest as the verb, functioning, or activity of the case.

Designing the case study approach

Yin’s approach to a case study is rooted in a formal proposition or theory which guides the case and is used to test the outcome. 1 Stake 5 advocates for a flexible design and explicitly states that data collection and analysis may commence at any point. Merriam’s 24 approach blends both Yin and Stake’s, allowing the necessary flexibility in data collection and analysis to meet the needs.

Yin 30 proposed three types of case study approaches—descriptive, explanatory, and exploratory. Each can be designed around single or multiple cases, creating six basic case study methodologies. Descriptive studies provide a rich description of the phenomenon within its context, which can be helpful in developing theories. To test a theory or determine cause and effect relationships, researchers can use an explanatory design. An exploratory model is typically used in the pilot-test phase to develop propositions (eg, Sibbald et al. 31 used this approach to explore interprofessional network complexity). Despite having distinct characteristics, the boundaries between case study types are flexible with significant overlap. 30 Each has five key components: (1) research question; (2) proposition; (3) unit of analysis; (4) logical linking that connects the theory with proposition; and (5) criteria for analyzing findings.

Contrary to Yin, Stake 5 believes the research process cannot be planned in its entirety because research evolves as it is performed. Consequently, researchers can adjust the design of their methods even after data collection has begun. Stake 5 classifies case studies into three categories: intrinsic, instrumental, and collective/multiple. Intrinsic case studies focus on gaining a better understanding of the case. These are often undertaken when the researcher has an interest in a specific case. Instrumental case study is used when the case itself is not of the utmost importance, and the issue or phenomenon (ie, the research question) being explored becomes the focus instead (eg, Paciocco 32 used an instrumental case study to evaluate the implementation of a chronic disease management program). 5 Collective designs are rooted in an instrumental case study and include multiple cases to gain an in-depth understanding of the complexity and particularity of a phenomenon across diverse contexts. 5 , 23 In collective designs, studying similarities and differences between the cases allows the phenomenon to be understood more intimately (for examples of this in the field, see van Zelm et al. 33 and Burrows et al. 34 In addition, Sibbald et al. 35 present an example where a cross-case analysis method is used to compare instrumental cases).

Merriam’s approach is flexible (similar to Stake) as well as stepwise and linear (similar to Yin). She advocates for conducting a literature review before designing the study to better understand the theoretical underpinnings. 24 , 25 Unlike Stake or Yin, Merriam proposes a step-by-step guide for researchers to design a case study. These steps include performing a literature review, creating a theoretical framework, identifying the problem, creating and refining the research question(s), and selecting a study sample that fits the question(s). 24 , 25 , 36

Data collection and analysis

Using multiple data collection methods is a key characteristic of all case study methodology; it enhances the credibility of the findings by allowing different facets and views of the phenomenon to be explored. 23 Common methods include interviews, focus groups, observation, and document analysis. 5 , 37 By seeking patterns within and across data sources, a thick description of the case can be generated to support a greater understanding and interpretation of the whole phenomenon. 5 , 17 , 20 , 23 This technique is called triangulation and is used to explore cases with greater accuracy. 5 Although Stake 5 maintains case study is most often used in qualitative research, Yin 17 supports a mix of both quantitative and qualitative methods to triangulate data. This deliberate convergence of data sources (or mixed methods) allows researchers to find greater depth in their analysis and develop converging lines of inquiry. For example, case studies evaluating interventions commonly use qualitative interviews to describe the implementation process, barriers, and facilitators paired with a quantitative survey of comparative outcomes and effectiveness. 33 , 38 , 39

Yin 30 describes analysis as dependent on the chosen approach, whether it be (1) deductive and rely on theoretical propositions; (2) inductive and analyze data from the “ground up”; (3) organized to create a case description; or (4) used to examine plausible rival explanations. According to Yin’s 40 approach to descriptive case studies, carefully considering theory development is an important part of study design. “Theory” refers to field-relevant propositions, commonly agreed upon assumptions, or fully developed theories. 40 Stake 5 advocates for using the researcher’s intuition and impression to guide analysis through a categorical aggregation and direct interpretation. Merriam 24 uses six different methods to guide the “process of making meaning” (p178) : (1) ethnographic analysis; (2) narrative analysis; (3) phenomenological analysis; (4) constant comparative method; (5) content analysis; and (6) analytic induction.

Drawing upon a theoretical or conceptual framework to inform analysis improves the quality of case study and avoids the risk of description without meaning. 18 Using Stake’s 5 approach, researchers rely on protocols and previous knowledge to help make sense of new ideas; theory can guide the research and assist researchers in understanding how new information fits into existing knowledge.

Practical applications of case study research

Columbia University has recently demonstrated how case studies can help train future health leaders. 41 Case studies encompass components of systems thinking—considering connections and interactions between components of a system, alongside the implications and consequences of those relationships—to equip health leaders with tools to tackle global health issues. 41 Greenwood 42 evaluated Indigenous peoples’ relationship with the healthcare system in British Columbia and used a case study to challenge and educate health leaders across the country to enhance culturally sensitive health service environments.

An important but often omitted step in case study research is an assessment of quality and rigour. We recommend using a framework or set of criteria to assess the rigour of the qualitative research. Suitable resources include Caelli et al., 43 Houghten et al., 44 Ravenek and Rudman, 45 and Tracy. 46

New directions in case study

Although “pragmatic” case studies (ie, utilizing practical and applicable methods) have existed within psychotherapy for some time, 47 , 48 only recently has the applicability of pragmatism as an underlying paradigmatic perspective been considered in HSR. 49 This is marked by uptake of pragmatism in Randomized Control Trials, recognizing that “gold standard” testing conditions do not reflect the reality of clinical settings 50 , 51 nor do a handful of epistemologically guided methodologies suit every research inquiry.

Pragmatism positions the research question as the basis for methodological choices, rather than a theory or epistemology, allowing researchers to pursue the most practical approach to understanding a problem or discovering an actionable solution. 52 Mixed methods are commonly used to create a deeper understanding of the case through converging qualitative and quantitative data. 52 Pragmatic case study is suited to HSR because its flexibility throughout the research process accommodates complexity, ever-changing systems, and disruptions to research plans. 49 , 50 Much like case study, pragmatism has been criticized for its flexibility and use when other approaches are seemingly ill-fit. 53 , 54 Similarly, authors argue that this results from a lack of investigation and proper application rather than a reflection of validity, legitimizing the need for more exploration and conversation among researchers and practitioners. 55

Although occasionally misunderstood as a less rigourous research methodology, 8 case study research is highly flexible and allows for contextual nuances. 5 , 6 Its use is valuable when the researcher desires a thorough understanding of a phenomenon or case bound by context. 11 If needed, multiple similar cases can be studied simultaneously, or one case within another. 16 , 17 There are currently three main approaches to case study, 5 , 17 , 24 each with their own definitions of a case, ontological and epistemological paradigms, methodologies, and data collection and analysis procedures. 37

Individuals’ experiences within health systems are influenced heavily by contextual factors, participant experience, and intricate relationships between different organizations and actors. 55 Case study research is well suited for HSR because it can track and examine these complex relationships and systems as they evolve over time. 6 , 7 It is important that researchers and health leaders using this methodology understand its key tenets and how to conduct a proper case study. Although there are many examples of case study in action, they are often under-reported and, when reported, not rigorously conducted. 9 Thus, decision-makers and health leaders should use these examples with caution. The proper reporting of case studies is necessary to bolster their credibility in HSR literature and provide readers sufficient information to critically assess the methodology. We also call on health leaders who frequently use case studies 56 – 58 to report them in the primary research literature.

The purpose of this article is to advocate for the continued and advanced use of case study in HSR and to provide literature-based guidance for decision-makers, policy-makers, and health leaders on how to engage in, read, and interpret findings from case study research. As health systems progress and evolve, the application of case study research will continue to increase as researchers and health leaders aim to capture the inherent complexities, nuances, and contextual factors. 7

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How to write a case study: The ultimate guide + examples and templates

It would be great if we could wave a magic wand to convince prospects to buy your product or service… But we can’t. So, a case study is your next best option. 

They’re a powerful sales and marketing tool for those prospects that are sitting on the fence. The problem is, they’re often dry, bland, and anything but magical. Never fear, though, as we’ve done some in-depth case study analysis.

We’re here to show you how to write a case study that will convince customers to choose you over your competitors. To create something so compelling they’ll have no doubt about your ability to deliver results.

Whether this is your first or 100th stab at it, we’ve got you covered with tips and best practices, real-world examples, and ideas for how to format a case study.  

In this post, we’ll look at:

• What a case study is and why you need one
• What makes a good case study

What should a case study include?

Essential prep for creating a case study.

• How to write a good case study in 5 steps
• 8 further case study best practices
• 7 real-life case study examples
• 8 case study templates to get you started

🔍 Are you looking for some case study examples? This compilation of case study data and leadership input from just a few RingCentral SMB customers will show you exactly how they have modernized their business communication processes.  

What is a case study and why should you create one?

A case study is basically a document— or it can be a video—that outlines how a customer used your product to overcome a problem. It’s real-world proof that your product works and gets results.

If your product or service has helped customers get great results, a case study will help you showcase those results to your future customers. They’re an excellent way to attract more business, and can mean the difference between a lost opportunity and a really good end-of-quarter.

Why are case studies important?

Case studies present a living, breathing witness to how effective your product or service is. In other words, they represent the ultimate in social proof. While customer reviews can also be valuable in influencing a potential client’s decision to buy from your company, they don’t pack the punch that case studies do.

That’s because with case studies, you can curate a story that highlights how well your product or service solved a real-life problem, and back it up with solid data. It demonstrates the value of your offering, while showing off your hard work in achieving success for a customer.

Case studies are relatable

Because you’re using real-world examples, rather than abstract concepts of what your product or service represents, case studies are fully relatable to potential new customers. 

They can put themselves in the shoes of the subject and empathize with their pain points—and realize that there’s a way to get similar results for themselves.

They’re unbiased

Whereas a landing page or product page can be purely self-promotional, a case study comes across as more authentic and unbiased. Instead of you saying how awesome your product is, the subject is saying it, and that counts for a lot. 

If they’ve switched to you from a competitor, that’s even better as it positions your product as superior without you having to spell it out.

They increase your authority

Case studies also demonstrate your ability to solve problems for your customers, positioning you as experts in your industry and building trust. The more case studies you have, the more established you’ll look. As in: “Wow, they have so many happy clients—they must be doing something right!”

They inspire readers

A narrative that’s engaging to read will get people interested in your company and inspire them to take a look around your website. And case studies give readers variety alongside other content formats such as product pages and blogs. They’re also an extra opportunity to add a CTA and nudge readers toward taking an action.

They have many uses

Case studies are versatile. You can publish and promote them in various places alongside your website—give a taster in social media posts with a link to the full article, add the video to your YouTube channel, share the stories in sales presentations. You can also extract elements like quotes from featured customers and repurpose them in other content, such as infographics.

In most cases it’s best to have case studies easily available on your website, not as downloadable gated content, but you do have this option for lead generation. You could write a blog post with a short version of the story, and offer the full version to readers in return for giving you their contact details.

They encourage loyalty

When you ask an existing customer to be the subject of a case study, it not only makes them feel special but it also reminds them of the benefits of your solution—which helps to reaffirm their loyalty. Plus, they’re getting extra brand exposure and a backlink to their own website, which boosts both their traffic and their authority online.  

In fact, there’s nothing to stop you reaching out to former customers who achieved good results with you before moving on (it happens). You never know, a reminder of you might even bring them back!

What makes a good case study? 

First, it’s helpful to highlight what makes a lot of case studies bad: most are painfully boring. What they have is research and detail, but what they lack is a cohesive, consumable story. 

They list numbers and contain data, but the reader isn’t sure what it all means or why it’s relevant to their problem. They end up existing as technical documents that do little to persuade or excite anyone. That’s unfortunate because they have the potential to be a powerful sales tool that can help you close big deals in the decision-making phase. 

So how do you write a case study that’s actually effective, then? Here are three characteristics every good case study should have:

It’s digestible

There’s no hard and fast rule on how long a case study should be. But it’s always a good idea to ask “how short can we make it?” 

A good case study avoids the unnecessary minutiae, knows what it’s trying to say, and communicates it quickly and without ambiguity. With a few exceptions, effective case studies are concise and clear. 

It’s thorough

On the other side of the length equation, being thorough is also important. Case study writing is all about making impressive claims about how a product helped someone achieve a certain result. However, it also needs to explain how it happened. 

Good case studies include key details that show how the customer got from A to B using the product—something you don’t get with customer reviews . Don’t make your reader work too hard to visualize the story. If you can use images and videos, use them.

It’s a story

Yes, case studies are sales tools. But the ones really worth reading tell a compelling story with a beginning, middle, and end. They beg to be read all the way through. Often, they present a problem that creates tension and demands a solution. And remember, in this story, the customer is the hero—not you.

Caveat: There is no one-size-fits-all approach for what to include in a case study. But, in general, there is a recognized case study format with certain sections you should feature to make it clearer and more impactful.  This format typically includes:

• Title: This should be concise and engaging. Naming your document “A Case Study of RingCentral” sounds dry. A headline like “Navigating Communications in a Remote World: A RingCentral Case Study” has more impact and explains what theme you’re exploring.
• Executive summary: Consider this like an abstract. Provide a brief overview of the case study, including the key purpose, approaches, findings, and solutions, without giving too much away.
• Introduction: Provide essential details about the customer in context.
• Challenges: Here’s where you highlight where your customer was before using your product or service and where they wanted to be. Present raw data where applicable and discuss any other background information that shows their struggles.
• Solution: Here’s where you get to show off. Explain how and why the customer chose your company, and how a specific product or service helped them achieve their objectives.
• Results: Time to get tangible. Dive into how the customer used your product, the results they saw, and long-lasting benefits. Incorporate any testimonials and statistics that showcase these results.
• Conclusion: Case studies are just as much about the future as the present. Use this closing section to highlight where your case study customer is going next thanks to your solution. Consider including a call-to-action here to encourage your prospect to take the next step.

How long should a case study be?

There isn’t a definitive answer to this question, as the length of a case study can vary depending on factors such as the size of the project you’re talking about. It also depends on the type of case study—for example, if it’s in the form of a video then a couple of minutes is enough. (We’ll explore the different types a little later on in this post.)

Balance is the key here. You’ll need to to include enough information to convey the story properly and hook the reader in, but not so much that they get overwhelmed or the message of the story gets lost amid the detail. The last thing you want them to think is “TL;DR”.

It’s about being concise, and not allowing yourself to get carried away with the story. Only include what needs to be included, so that readers can clearly understand the subject’s pain point, the reason your solution was a good fit, and the success it achieved.

Remember that not every part of the case study has to be in narrative form. You can pull out stats and display them as graphics, highlight direct quotes or other key information, or add a photo of the subject. If your case study is on the longer side, break up the text with subheadings, bullet points, and white space.

Before you start actually writing, there’s a bit of prep work you’ll need to do to make sure your case study is amazing.

1. Choose your customer

You may have many customers who’ve seen great results using your product (let’s hope!). But you can’t just pick a name out of a hat and showcase their results. So, what’s the best way of selecting a client for a case study?

Steer clear of customers who may not be the right fit for your audience or whose results may not be typical.

For example, don’t feature an enterprise company when most of your customers are small businesses. Or a business achieving a 90% customer retention rate when most of them see 70% on average (still impressive, though).

When considering which customer to use, start by creating a list of customers that meet these criteria:

They’ve seen good results with your product or service

The numbers are what really matter. So choose customers that have seen strong results using your product (like Conair did with RingCentral). But be careful about showcasing exceptionally good results if they’re not likely to be repeated by most.

They have a respected and recognizable brand

Strong brands give your product instant social proof. They prove that you’re established and trustworthy. That alone can make you a front-runner in the decision-making process. After all, if Big Brand X trusts you, so can a prospect.

They’re a typical customer

Good results don’t carry as much weight when they’re achieved by companies in other industries or verticals. Identify current customers that are similar to your target audience. A client who has faced similar challenges and pain points will evoke empathy and stir up interest in the mind of your prospective clients.

So, if you sell enterprise software, choose enterprise customers. If you’re a consultant in the healthcare industry, choose a customer that works in healthcare.

With your list in hand, you can start reaching out. Picking up the phone can be a lot more effective than sending an email. It’s more personal, lets you build rapport, and is harder to ignore. 

Try to get in touch with customers who use or are very familiar with your product or service—someone who can speak to results. Tell them you’re interested in writing a case study and you’d love to hear more about the results they’ve achieved. Be clear about what the process involves on their part—whether it’s a list of questions in an email, a phone call, or if it involves a camera and crew.  

If you’ve provided value, your customer is more likely to see you as a partner rather than a vendor and, hopefully, will be happy to participate. Remember, you’re also shining a spotlight on their own success. So it’s a win-win.  

That said, you may hear “no” a few times, too. Don’t get discouraged. Some customers will decline for different reasons, regardless of the results they’ve achieved with your product.

RingCentral: W2O

2. Begin your research

Start collecting information about your customer. This is easier if you work as a team. From sales to content marketing to customer service, everyone who’s been in touch with customers will have insight about their experience.

They can help you understand what your customers do and sell, and what challenges they’re facing. Identify the stakeholders you need to speak with—anyone in the company who uses your product—from the CEO to the marketing intern. Collect stats, even ones you don’t think are relevant—they may be later.

3. Ask the right questions

Smart questions get insightful answers. Here are some examples of great questions to start with: 

• “What were some of the bigger challenges you faced before using our product?”
• “How does our product help you reach your individual goals?”
• “Which key metrics have improved most since using our product/service?”
• “Which parts of your business have been impacted most, and how?”
• “How long did it take to roll out our product?”

But don’t stop there. Use these questions to segue into deeper, more targeted questions that underscore the real-world benefits of your product. Let the conversation flow naturally—this is the magic of interviews. You can’t always plan for what interesting topics come up next.

4. Identify your target audience

Beyond your customer’s industry, consider who the target audience of the case study is. Who will see it? What group of people does it need to influence?

While it’s often high-level executives who make large purchase decisions, employees at all levels can act as a champion for your product or brand. Your case study may have to persuade an IT worker that your product or service is going to make their job easier. Meanwhile, it may also need to convince the CFO that they’ll see a real return on investment.

5. Identify the top three things you want to highlight

During the initial research phase, you’ve likely uncovered a lot of interesting information about your customer and their experiences with your product. 

While it might be tempting to use it all, when you write a case study, you should quickly and clearly communicate the value of your product. Go through this information and identify the three most important business results you want to feature, like we did in the Barx Parx example shown below.

Stats and key performance indicators (KPIs) to consider using in your case study:

• Ramp up time : How long did it take to get started with your product? Did it improve any other facet of their workflow? 
• Sales results : How did the product impact your customer’s bottom line?
• Total return on investment (ROI) : How long did it take to earn more than they spent on your product?
• Productivity increases : Which teams saw improvements in process and workflow? And by how much?

6. Choose your format

So, what does a case study look like visually? It doesn’t have to exist only as a PDF attachment in a late-stage deal email (although there’s nothing wrong with that). Consider the format. Think about who’s going to read it (or watch it). 

Do you want to turn this into fancy interactive content? Does your prospect have the time and interest to dig into the details? Or do they just want the facts? Choose the format that you think best engages the audience that you’re selling to. 

Here are some options:

Report format

This long-form document has been the gold standard for B2B case studies for many years. It’s effective when the subject matter is complex and demands detail.

Here’s how Zendesk presented their case study with IDC as a report .

Remember, a CTO who’s evaluating large-scale business communications platforms for a multi-year deal is going to want more information than a marketing manager who’s evaluating a new social media ad platform.

Keeping things short and sweet is often the best way to get your message heard. By focusing on the key points, you can highlight the biggest wins at just a glance. 

Most report format case studies can be easily condensed into a one-page document. This is ideal for prospects (and salespeople) who are short on time and prefer something they can quickly scan.

Few things can tell a story the way that video can, and case studies are no exception. They give you an unmatched level of creative freedom and storytelling using music, lighting, pacing, and voice that can evoke emotions and persuade someone using more than just numbers and facts. 

And at just a couple of minutes long, they can do a lot of heavy lifting in not a lot of time.

Dropbox: Expedia

Infographic

If you’re wondering how to make a case study more memorable, it’s worth noting that people love infographics. They’re an excellent way to convey important data in a simple, eye-pleasing way.

If your case study requires you to use a lot of data to prove a point—or if visualizing data can make the results more clear—building an infographic case study can be a great investment.

How to write a case study in 5 steps

Congrats. You’ve done the research. You’ve made the calls. You’ve pored over all the details. Now, all you have to do is write. 

Here are five simple steps that’ll help you better understand how to create a case study that champions your customer and clearly showcases the real-world value of your products or services. 

1. Introduce the customer

Set the stage for your case study with an introduction. Briefly explain who your customer is with a bit of background information that can include their industry, product, company size, and location. 

You don’t have to dig into the nuts and bolts of their business, but you do want the reader to understand who they are and what they do. The more color you can provide here, the more impactful it’ll be when you show the awesome results this customer saw because they chose you.

2. State the problem

Every product or service is a possible solution to a problem. Explain the problem (or problems) that you helped your customer overcome. Describe the larger impact of the issue. Maybe it was customers leaving. Perhaps it was bad leads—or good leads that were never followed up on.

Use this as an opportunity to clearly show what was at stake, and make sure you leave the jargon out of it. Frame the problem in simple terms that any reader can understand. 

3. Introduce your product

This is where you begin solving the problem. Briefly introduce your proposed solution and what it does.

Start on a general level, then apply it to the challenge the customer was experiencing. Talk about which teams or individuals used your product and how they used it. Be sure to make the connection between the customer’s problem and your solution crystal clear.

4. Show results

The big reveal. What kind of results was your customer able to achieve using your product or service? Speak to how they solved the problem descriptively, but also with cold, hard numbers. 

Not everything can be measured in numbers (sometimes, peace of mind is a powerful benefit all on its own), but whenever you can, back up your story with the stats. At the very least, this will make it easy for a CFO—or a prospective customer who wants to buy—to justify buying your product.

For example: 

The customer saw a 33% increase in web traffic, a large influx of social media activity, and a 10% boost in revenue over the duration of the campaign.

5. Prove it

Don’t forget to show your math. How you get the results is just as important as the results themselves. What specific steps were taken to get those results? Not only will this help validate your claims, it makes it easier to envision how the reader may be able to achieve them, too.

8 Further case study best practices

That’s how to write a case study in broad strokes, but you might be wondering how to write a business case study that stands out from the crowd? Here are some top tips:

1. Avoid jargon 

As a subject matter expert in your line of work, it can be tempting to go into as much jargony detail as possible. This is normal as it’s often the language we use at work every day. 

Remember, though, that your customer probably doesn’t speak that language. When in doubt, try to put yourself in the shoes of someone who doesn’t live and breathe your product or industry.. 

2. Spend time on your title

It’s tempting to use the case study’s most interesting or impressive KPI as your title. But that also gives away the ending before the story begins, and skips details that are important for context in the process. Try writing a title that piques interest without being a spoiler.

3. Edit. Then edit again. 

Once you’ve got your first draft completed (and the jargon removed), edit the case study. When writing case studies, one proofread is never enough. A few best practices here:

• Look for and eliminate unnecessary adjectives—simple English is better.
• Speak in an active voice. 
• Look for details that get in the way of the story. 

And then do it all over again until you can’t edit it down anymore without losing the essence of the story.

4. Pay attention to the imagery

Well-designed charts, graphs, images, or infographics can do the heavy lifting of several pages of text in just seconds. 

They can also help break up large pieces of text, making the case study easier to read—and nicer to look at. After all, the end goal is to have these read all the way through.

Here’s an example of a graphic from a longer CPA Canada infographic (that includes a short case study embedded inside it): 

5. Pull quotes

Hard data and results are good. But a customer quote is a great piece of social proof and adds a human element to your case study. And that makes your results more believable. 

Here’s an example of what that looks like, from a RingCentral case study :

6. Make it scannable

Some people will take the time to read your case study front to back and absorb every detail. Some won’t give it more than a single glance. And sometimes, that person is the decision-maker. 

Make the most important results easy to spot, read, and retain at a glance. Write headings that are descriptive—if someone just scanned them, would they be able to get the gist of the story? Consider putting a summary at the very beginning of the study, or call out impressive results in a larger font size.

7. Record your interviews

Ditch the pen and paper. If you’re conducting one-on-one interviews over the phone, you can save yourself a lot of time and energy by recording the conversation (with your customer’s consent, of course). 

There are tools that can make this easier too—you might find one or two in your marketing stack. For example, you could use RingSense AI for automatic note taking, summarizing, and transcribing.

8. Don’t forget the call to action (CTA)

Your prospect is excited because your case study has done an excellent job of showing how your product or service can help drive results for customers. Now, how do they get in touch with you to learn more? 

Whether it’s a button that links to your website, an email address, or a phone number, make sure there’s an easy way of getting in touch with you in the case study.

7 Examples of great case studies from real-life companies

So, that’s the theory covered, but what do great case studies look like in practice? We’ve included a few elements from RingCentral customer stories as examples above, but let’s dig a little deeper into two more of our case studies:

RingCentral: How Ryder made significant savings with cloud communications

This case study is about Ryder Systems, a Fortune 500 transportation company who modernized their IT communications infrastructure with RingCentral.

We start off with a subheading that sums up the story, plus the key stats at a glance. There’s another stats panel farther down the page to help break up the wall of text. Pull quotes also achieve this, but that’s not the only reason why we like to use quotes.

When the quote comes directly from a senior manager at the company we’ve helped, they’re telling an important part of the story in their own words. In this case, there’s a reference to the amount of money Ryder has saved with RingCentral, and a mention of the platform’s all-in-one cloud capabilities.

The content introduces Ryder and makes it clear that they are a big name in transportation (the single largest truck supplier in the US) and a noteworthy firm in general, as evidenced by membership of the Fortune 500 and Forbes’ Most Admired Companies. 

If a big player like this is happy to trust RingCentral with their business, that says a lot about our credentials too.

We mentioned earlier that customers are attracted to testimonials from companies similar to themselves. But RingCentral caters to businesses of all sizes—so if SMBs are reading this case study, we think they’ll see our association with a large company as “social proof” and a sign of our trustworthiness across the board.

The story goes on to explore Ryder’s pain points and how RingCentral solved them, inspiring other companies with similar problems to take action (i.e. to replace legacy systems that are slow and expensive). For further encouragement, it details how Ryder were so happy with the initial success that they also went on to implement RingCentral’s contact center solution.

RingCentral: Helping Dispute Nation to change lives

Just to illustrate our point about RingCentral serving all sizes of business, here’s a case study for a much smaller company—consumer advocacy organization Dispute Nation, which has 10 employees.

Again, the story begins with stats and a pull quote from a company representative. In keeping with Dispute Nation’s values, it focuses less on the financial savings or efficiency brought by RingCentral tools but on how our solution helps this company to help others.

Drawing empathy from other startups and fast-growing small businesses, we mention how demand for the company’s services grew very quickly. This makes it obvious why they needed a unified communications system to reach all their clients by phone, SMS, and fax.

The case study highlights how digital fax in particular helps Dispute Nation to get client cases resolved sooner. Another pull quote mentions some of the other benefits of RingCentral, like automation and integrations with other tools. 

There are nods to mobility and flexibility, plus security and data privacy which will resonate with other highly-regulated industries.

The tale finishes strongly with the company founder’s assertion that “RingCentral is helping Dispute Nation improve more lives”. Readers who’ve been inspired to learn more can easily navigate from this page to explore products, resources, and get in touch.

RingCentral is far from the only company to have recognized the importance of this kind of content.

Here are some more real-life case studies from other businesses you might just recognize:

RingCentral iswe’re far from the only company to have recognized the importance of this kind of content.

Mailchimp: Make a connection in real life with postcards

What we like about it: The title doesn’t give everything away all at once, and the case study tells a story with a beginning, middle, and end. The sections are clearly titled and organized, and the results are easy to find. As a bonus: the video adds a believable human element.

LinkedIn: How Adobe achieves alignment and ABM success with LinkedIn

What we like about it: It’s detailed without being a novella. It understands and speaks to the enterprise customer. The key points are in bullet format and easy to read. The important wins are highlighted. And the video makes the content easy to engage with.

Hootsuite: How Meliá became one of the most influential hotel chains on social media

What we like about it: The title makes you want to read the whole customer story. They’ve embedded a well-produced video high on the page, so you can choose to watch it before you read on. The design and layout of the page makes the content and images easy to consume, and the results can’t be missed. Also, they weren’t shy about adding CTAs.

Slack: So yeah, we tried Slack

What we like about it: This case study follows the tried and true format of customer, problem, solution, and results. It uses humor and relatable characters throughout to support the story and keep your attention. And it’s only two minutes long so it gets the point across quickly.

Assetworks: South Carolina School Board Insurance Trust

What we like about it: This case study tackles the otherwise complex and technical topic, and simplifies it as an infographic using images to make the results clear. It’s concise and easy to follow because you can see the math without actually doing any math.

8 Case study templates to get you started

Starting from scratch can be time-consuming. To help you, we’ve drawn together a few templates:

The generic one

Generic doesn’t mean boring! Canva’s templates are great if you need something concise and simple that still looks professional . A free account will give you access to several well-designed templates, including this one :

The layout is provided for you, so it’s quick and easy to customize with your branding and content. Don’t be afraid to use this as a foundation, then add in visual elements like infographics and videos.

The data-driven one

If your key messages revolve around numbers, start with a template structure that lets you highlight these. HubSpot has a data-focused template where you can pack in graphs, charts, and other visuals to drive your message home:

The industry-specific one

Not every template suits every company. Visme offers different templates created for different industries, including real estate, financial services, and healthcare.

The problem-solution-impact one

This format takes a graphical rather than narrative approach, which helps readers to visualize the events and looks colorful and appealing on the page. The template is available as a free download from Smartsheet:

The idea of this is to present the story in a logical and sequential way. It starts with the challenge faced by the subject of the case study, looks at the solution your company provided, and shows what the outcome was.

Of course, you could choose to combine this with other elements like text content, stats, and quotes—making the “problem-solution-impact” graphic the main focus of the case study.

The product-specific one

You can choose to focus your case study on a particular product, highlighting key features and the  practical applications in the real world. 

It leans into the experience that the customer has had with the product—i.e., what it feels like to use it—and the specific benefits. This one is a good choice if the customer hasn’t been using the product for very long, and you haven’t yet gathered a lot of metrics.

HubSpot has a template for this purpose :

The in-depth report one

Using the style of an in-depth report can be useful when you’ve worked with the customer on a complex project and you need to include a lot of detail.  

This template —another free one from Smartsheet—includes elements like decision criteria, data analysis, and the implementation plan:

Just be careful with this one as you don’t want readers to be put off by a lot of text. Make sure the style is conversational and engaging, not dry and formal.

The employee story one

Okay, stick with us here—this one’s a little different. As well as asking customers to tell their stories, how about getting employees to share what it’s like to work for your company, or their experience of working on a particular project?

Employee stories or testimonials are often used for recruitment purposes, but they’re also a valuable form of marketing for potential customers. That’s because happy, engaged employees represent a company that cares about its people, which all helps you to build trust.

This example from Vanguard isn’t a template as such, but you can use it to inspire your own version. (It doesn’t have to be a video—you could still use a written narrative with direct quotes, photos, and stats on employee satisfaction.)

BONUS TEMPLATE: Form for customers participating in case studies

Earlier in this post, we briefly covered some of the questions you’ll need to ask your customers when putting together case studies. But it’s always helpful to have a visual guide, so we’re including this template from Vitally , which provides a framework for collaborating with customers and collecting the relevant data. 

You can adapt this to your own needs by adding further questions.

The final word on how to write a case study…

Sure, an ad or boosted social media post can make someone aware of your brand or that your product exists, and a landing page can tell them how your product can solve their problem. 

But there’s nothing quite as powerful as someone else singing your praises. 

And that’s exactly what a case study does. Spend the time to do it right and it has the potential to deliver huge ROI no matter how big or small your company is. And not just once—but over and over again.

Originally published Jun 15, 2024, updated Aug 15, 2024

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What the Case Study Method Really Teaches

by Nitin Nohria

Summary .   

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?”

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Characteristics of a Case Study

Although case study research may be applied to many settings for many reasons, in this chapter we will focus on its use in illuminating educational and social programs. Program case study designs begin by identifying the specific program to be investigated followed by the selection of specific aspects that will be thoroughly studied. Unless very small and uncomplicated, most programs cannot be studied in their entirety. The selected program elements are then clarified using research questions that will guide the actual case study. Answering these questions through several forms of data collection becomes the principal task of the case study researcher.

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Case Study Method | Characteristics, Advantages & Limitations of Case Study Method

Posted by Md. Harun Ar Rashid | Aug 5, 2021 | Research Methodology

Case Study Method

The case study method is a very popular form of qualitative analysis and involves a careful and complete observation of a social unit, be that unit a person, a family, an institution, a cultural group, or even the entire community. It is a method of study in depth rather than breadth. The case study places more emphasis on the full analysis of a limited number of events or conditions and their interrelations. The case study deals with the processes that take place and their interrelationship. Thus, the case study is essentially an intensive investigation of the particular unit under consideration. The object of the case study method is to locate the factors that account for the behavior patterns of the given unit as an integrated totality.

“The case study method is a technique by which individual factor whether it be an institution or just an episode in the life of an individual or a group is analyzed in its relationship to any other in the group.” ( H. Odum )

“A comprehensive study of a social unit be that unit a person, a group, a social institution, a district or a community.” ( Pauline V. Young )

The case study method is a form of qualitative analysis wherein careful and complete observation of an individual or a situation or an institution is done; efforts are made to study each and every aspect of the concerning unit in minute details and then from case data generalizations and inferences are drawn.

Characteristics: The essential characteristics of the case study method are as under:

• The researcher can take one single social unit or more of such units for his study purpose, may even take a situation to study the same comprehensively.
• To obtain enough information for drawing correct inferences.
• To make a complete study of the social unit covering all facets.
• Try to understand the complex factors that are operative within a social unit as an integrated totality.
• The approach happens to be qualitative and not quantitative. Mere quantitative information is not collected. Every possible effort is made to collect information concerning all aspects of life.
• To know the mutual inter-relationship of causal factors.
• The behavior pattern of the concerning unit is studied directly and not by an indirect and abstract approach.
• It results in fruitful hypotheses along with the data which may be helpful in testing them, and thus it enables the generalized knowledge to get richer and richer.

Advantages: There are several advantages of the case study method, some of them are being:

• To understand fully the behavior pattern of the concerned unit.
• Helps to obtain a real and enlightened record of personal experiences.
• This method enables the researcher to trace out the natural history of the social unit and its relationship with the social factors and the forces involved in its surrounding environment.
• It helps in formulating relevant hypotheses along with the data which may be helpful in testing them.
• It facilitates the intensive study of social units that’s why the case study method is being frequently used, particularly in social researches.
• It helps a lot to the researcher in the task of constructing the appropriate questionnaire.
• The researcher can use different methods such as depth interviews, questionnaires, documents, study reports of individuals, and so on.
• It has proved beneficial in determining the nature of units to be studied along with the nature of the universe. So it is known as the “mode of organizing data”.
• It means to well understand the past of a social unit because of its emphasis on historical analysis, also it’s a technique to suggest measures for improvement in the context of the present environment of the concerned social units.
• It represents a real record of personal experiences which very often escape the attention of most of the skilled researchers using other techniques.
• It enhances the experience, analyzing ability, and skills of the researcher.
• It facilitates the drawing of inferences and helps in maintaining the continuity of the research process.

Limitations: Important limitations of the case study method may as well be highlighted.

• Case situations are seldom comparable and as such the information gathered in case studies is often not comparable. Since the subject under the case study tells history in his own words, logical concepts and units of scientific classification have to be read into it or out of it by the investigator.
• Read Bain does not consider the case data as significant scientific data since they do not provide knowledge of the “impersonal, universal, non-ethical, non-practical, repetitive aspects of phenomena.”8 Real information is often not collected because the subjectivity of the researcher does enter in the collection of information in a case study.
• The danger of false generalization is always there in view of the fact that no set rules are followed in the collection of the information and only a few units are studied.
• It consumes more time and requires a lot of expenditure. More time is needed under the case study method since one studies the natural history cycles of social units and that too minutely.
• The case data are often vitiated because the subject, according to reading Bain, may write what he thinks the investigator wants; and the greater the rapport, the more subjective the whole process is.
• The case study method is based on several assumptions which may not be very realistic at times, and as such, the use of case data is always subject to doubt.
• The case study method can be used only in a limited sphere, it is not possible to use it in the case of a big society. Sampling is also not possible under a case study method.
• Response of the investigator is an important limitation of the case study method. He often thinks that he has full knowledge of the unit and can himself answer about it. In case the same is not true, then consequences follow. In fact, this is more the fault of the researcher rather than that of the case method.

Despite the above-stated limitations, we find that case studies are being undertaken in several disciplines, particularly in sociology, as a tool of scientific research in view of the several advantages indicated earlier. Most of the limitations can be removed if researchers are always conscious of these and are well trained in the modern methods of collecting case data and in the scientific techniques of assembling, classifying, and processing the same. Besides, case studies, in modern times, can be conducted in such a manner that the data are amenable to quantification and statistical treatment. Possibly, this is also the reason why case studies are becoming popular day by day.

Reference:  Research Methodology written by C.R. Kothari

Former Student at Rajshahi University

About The Author

Md. Harun Ar Rashid

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15 Real-Life Case Study Examples & Best Practices

Written by: Oghale Olori

Case studies are more than just success stories.

They are powerful tools that demonstrate the practical value of your product or service. Case studies help attract attention to your products, build trust with potential customers and ultimately drive sales.

It’s no wonder that 73% of successful content marketers utilize case studies as part of their content strategy. Plus, buyers spend 54% of their time reviewing case studies before they make a buying decision.

To ensure you’re making the most of your case studies, we’ve put together 15 real-life case study examples to inspire you. These examples span a variety of industries and formats. We’ve also included best practices, design tips and templates to inspire you.

Let’s dive in!

Table of Contents

What is a case study, 15 real-life case study examples, sales case study examples, saas case study examples, product case study examples, marketing case study examples, business case study examples, case study faqs.

• A case study is a compelling narrative that showcases how your product or service has positively impacted a real business or individual. 
• Case studies delve into your customer's challenges, how your solution addressed them and the quantifiable results they achieved.
• Your case study should have an attention-grabbing headline, great visuals and a relevant call to action. Other key elements include an introduction, problems and result section.
• Visme provides easy-to-use tools, professionally designed templates and features for creating attractive and engaging case studies.

A case study is a real-life scenario where your company helped a person or business solve their unique challenges. It provides a detailed analysis of the positive outcomes achieved as a result of implementing your solution.

Case studies are an effective way to showcase the value of your product or service to potential customers without overt selling. By sharing how your company transformed a business, you can attract customers seeking similar solutions and results.

Case studies are not only about your company's capabilities; they are primarily about the benefits customers and clients have experienced from using your product.

Every great case study is made up of key elements. They are;

• Attention-grabbing headline: Write a compelling headline that grabs attention and tells your reader what the case study is about. For example, "How a CRM System Helped a B2B Company Increase Revenue by 225%.
• Introduction/Executive Summary: Include a brief overview of your case study, including your customer’s problem, the solution they implemented and the results they achieved.
• Problem/Challenge: Case studies with solutions offer a powerful way to connect with potential customers. In this section, explain how your product or service specifically addressed your customer's challenges.
• Solution: Explain how your product or service specifically addressed your customer's challenges.
• Results/Achievements : Give a detailed account of the positive impact of your product. Quantify the benefits achieved using metrics such as increased sales, improved efficiency, reduced costs or enhanced customer satisfaction.
• Graphics/Visuals: Include professional designs, high-quality photos and videos to make your case study more engaging and visually appealing.
• Quotes/Testimonials: Incorporate written or video quotes from your clients to boost your credibility.
• Relevant CTA: Insert a call to action (CTA) that encourages the reader to take action. For example, visiting your website or contacting you for more information. Your CTA can be a link to a landing page, a contact form or your social media handle and should be related to the product or service you highlighted in your case study.

Now that you understand what a case study is, let’s look at real-life case study examples. Among these, you'll find some simple case study examples that break down complex ideas into easily understandable solutions.

In this section, we’ll explore SaaS, marketing, sales, product and business case study examples with solutions. Take note of how these companies structured their case studies and included the key elements.

We’ve also included professionally designed case study templates to inspire you.

1. Georgia Tech Athletics Increase Season Ticket Sales by 80%

Georgia Tech Athletics, with its 8,000 football season ticket holders, sought for a way to increase efficiency and customer engagement.

Their initial sales process involved making multiple outbound phone calls per day with no real targeting or guidelines. Georgia Tech believed that targeting communications will enable them to reach more people in real time.

Salesloft improved Georgia Tech’s sales process with an inbound structure. This enabled sales reps to connect with their customers on a more targeted level. The use of dynamic fields and filters when importing lists ensured prospects received the right information, while communication with existing fans became faster with automation.

As a result, Georgia Tech Athletics recorded an 80% increase in season ticket sales as relationships with season ticket holders significantly improved. Employee engagement increased as employees became more energized to connect and communicate with fans.

Why Does This Case Study Work?

In this case study example , Salesloft utilized the key elements of a good case study. Their introduction gave an overview of their customers' challenges and the results they enjoyed after using them. After which they categorized the case study into three main sections: challenge, solution and result.

Salesloft utilized a case study video to increase engagement and invoke human connection.

Incorporating videos in your case study has a lot of benefits. Wyzol’s 2023 state of video marketing report showed a direct correlation between videos and an 87% increase in sales.

The beautiful thing is that creating videos for your case study doesn’t have to be daunting.

With an easy-to-use platform like Visme, you can create top-notch testimonial videos that will connect with your audience. Within the Visme editor, you can access over 1 million stock photos , video templates, animated graphics and more. These tools and resources will significantly improve the design and engagement of your case study.

Simplify content creation and brand management for your team

• Collaborate on designs , mockups and wireframes with your non-design colleagues
• Lock down your branding to maintain brand consistency throughout your designs
• Why start from scratch? Save time with 1000s of professional branded templates

Sign up. It’s free.

2. WeightWatchers Completely Revamped their Enterprise Sales Process with HubSpot

WeightWatchers, a 60-year-old wellness company, sought a CRM solution that increased the efficiency of their sales process. With their previous system, Weightwatchers had limited automation. They would copy-paste message templates from word documents or recreate one email for a batch of customers.

This required a huge effort from sales reps, account managers and leadership, as they were unable to track leads or pull customized reports for planning and growth.

WeightWatchers transformed their B2B sales strategy by leveraging HubSpot's robust marketing and sales workflows. They utilized HubSpot’s deal pipeline and automation features to streamline lead qualification. And the customized dashboard gave leadership valuable insights.

As a result, WeightWatchers generated seven figures in annual contract value and boosted recurring revenue. Hubspot’s impact resulted in 100% adoption across all sales, marketing, client success and operations teams.

Hubspot structured its case study into separate sections, demonstrating the specific benefits of their products to various aspects of the customer's business. Additionally, they integrated direct customer quotes in each section to boost credibility, resulting in a more compelling case study.

Getting insight from your customer about their challenges is one thing. But writing about their process and achievements in a concise and relatable way is another. If you find yourself constantly experiencing writer’s block, Visme’s AI writer is perfect for you.

Visme created this AI text generator tool to take your ideas and transform them into a great draft. So whether you need help writing your first draft or editing your final case study, Visme is ready for you.

3. Immi’s Ram Fam Helps to Drive Over $200k in Sales

Immi embarked on a mission to recreate healthier ramen recipes that were nutritious and delicious. After 2 years of tireless trials, Immi finally found the perfect ramen recipe. However, they envisioned a community of passionate ramen enthusiasts to fuel their business growth.

This vision propelled them to partner with Shopify Collabs. Shopify Collabs successfully cultivated and managed Immi’s Ramen community of ambassadors and creators.

As a result of their partnership, Immi’s community grew to more than 400 dedicated members, generating over $200,000 in total affiliate sales.

The power of data-driven headlines cannot be overemphasized. Chili Piper strategically incorporates quantifiable results in their headlines. This instantly sparks curiosity and interest in readers.

While not every customer success story may boast headline-grabbing figures, quantifying achievements in percentages is still effective. For example, you can highlight a 50% revenue increase with the implementation of your product.

Take a look at the beautiful case study template below. Just like in the example above, the figures in the headline instantly grab attention and entice your reader to click through.

Having a case study document is a key factor in boosting engagement. This makes it easy to promote your case study in multiple ways. With Visme, you can easily publish, download and share your case study with your customers in a variety of formats, including PDF, PPTX, JPG and more!

4. How WOW! is Saving Nearly 79% in Time and Cost With Visme

This case study discusses how Visme helped WOW! save time and money by providing user-friendly tools to create interactive and quality training materials for their employees. Find out what your team can do with Visme. Request a Demo

WOW!'s learning and development team creates high-quality training materials for new and existing employees. Previous tools and platforms they used had plain templates, little to no interactivity features, and limited flexibility—that is, until they discovered Visme.

Now, the learning and development team at WOW! use Visme to create engaging infographics, training videos, slide decks and other training materials.

This has directly reduced the company's turnover rate, saving them money spent on recruiting and training new employees. It has also saved them a significant amount of time, which they can now allocate to other important tasks.

Visme's customer testimonials spark an emotional connection with the reader, leaving a profound impact. Upon reading this case study, prospective customers will be blown away by the remarkable efficiency achieved by Visme's clients after switching from PowerPoint.

Visme’s interactivity feature was a game changer for WOW! and one of the primary reasons they chose Visme.

“Previously we were using PowerPoint, which is fine, but the interactivity you can get with Visme is so much more robust that we’ve all steered away from PowerPoint.” - Kendra, L&D team, Wow!

Visme’s interactive feature allowed them to animate their infographics, include clickable links on their PowerPoint designs and even embed polls and quizzes their employees could interact with.

By embedding the slide decks, infographics and other training materials WOW! created with Visme, potential customers get a taste of what they can create with the tool. This is much more effective than describing the features of Visme because it allows potential customers to see the tool in action.

To top it all off, this case study utilized relevant data and figures. For example, one part of the case study said, “In Visme, where Kendra’s team has access to hundreds of templates, a brand kit, and millions of design assets at their disposal, their team can create presentations in 80% less time.”

Who wouldn't want that?

Including relevant figures and graphics in your case study is a sure way to convince your potential customers why you’re a great fit for their brand. The case study template below is a great example of integrating relevant figures and data.

This colorful template begins with a captivating headline. But that is not the best part; this template extensively showcases the results their customer had using relevant figures.

The arrangement of the results makes it fun and attractive. Instead of just putting figures in a plain table, you can find interesting shapes in your Visme editor to take your case study to the next level.

5. Lyte Reduces Customer Churn To Just 3% With Hubspot CRM

While Lyte was redefining the ticketing industry, it had no definite CRM system . Lyte utilized 12–15 different SaaS solutions across various departments, which led to a lack of alignment between teams, duplication of work and overlapping tasks.

Customer data was spread across these platforms, making it difficult to effectively track their customer journey. As a result, their churn rate increased along with customer dissatisfaction.

Through Fuelius , Lyte founded and implemented Hubspot CRM. Lyte's productivity skyrocketed after incorporating Hubspot's all-in-one CRM tool. With improved efficiency, better teamwork and stronger client relationships, sales figures soared.

The case study title page and executive summary act as compelling entry points for both existing and potential customers. This overview provides a clear understanding of the case study and also strategically incorporates key details like the client's industry, location and relevant background information.

Having a good summary of your case study can prompt your readers to engage further. You can achieve this with a simple but effective case study one-pager that highlights your customer’s problems, process and achievements, just like this case study did in the beginning.

Moreover, you can easily distribute your case study one-pager and use it as a lead magnet to draw prospective customers to your company.

Take a look at this case study one-pager template below.

This template includes key aspects of your case study, such as the introduction, key findings, conclusion and more, without overcrowding the page. The use of multiple shades of blue gives it a clean and dynamic layout.

Our favorite part of this template is where the age group is visualized.

With Visme’s data visualization tool , you can present your data in tables, graphs, progress bars, maps and so much more. All you need to do is choose your preferred data visualization widget, input or import your data and click enter!

6. How Workato Converts 75% of Their Qualified Leads

Workato wanted to improve their inbound leads and increase their conversion rate, which ranged from 40-55%.

At first, Workato searched for a simple scheduling tool. They soon discovered that they needed a tool that provided advanced routing capabilities based on zip code and other criteria. Luckily, they found and implemented Chili Piper.

As a result of implementing Chili Piper, Workato achieved a remarkable 75–80% conversion rate and improved show rates. This led to a substantial revenue boost, with a 10-15% increase in revenue attributed to Chili Piper's impact on lead conversion.

This case study example utilizes the power of video testimonials to drive the impact of their product.

Chili Piper incorporates screenshots and clips of their tool in use. This is a great strategy because it helps your viewers become familiar with how your product works, making onboarding new customers much easier.

In this case study example, we see the importance of efficient Workflow Management Systems (WMS). Without a WMS, you manually assign tasks to your team members and engage in multiple emails for regular updates on progress.

However, when crafting and designing your case study, you should prioritize having a good WMS.

Visme has an outstanding Workflow Management System feature that keeps you on top of all your projects and designs. This feature makes it much easier to assign roles, ensure accuracy across documents, and track progress and deadlines.

Visme’s WMS feature allows you to limit access to your entire document by assigning specific slides or pages to individual members of your team. At the end of the day, your team members are not overwhelmed or distracted by the whole document but can focus on their tasks.

7. Rush Order Helps Vogmask Scale-Up During a Pandemic

Vomask's reliance on third-party fulfillment companies became a challenge as demand for their masks grew. Seeking a reliable fulfillment partner, they found Rush Order and entrusted them with their entire inventory.

Vomask's partnership with Rush Order proved to be a lifesaver during the COVID-19 pandemic. Rush Order's agility, efficiency and commitment to customer satisfaction helped Vogmask navigate the unprecedented demand and maintain its reputation for quality and service.

Rush Order’s comprehensive support enabled Vogmask to scale up its order processing by a staggering 900% while maintaining a remarkable customer satisfaction rate of 92%.

Rush Order chose one event where their impact mattered the most to their customer and shared that story.

While pandemics don't happen every day, you can look through your customer’s journey and highlight a specific time or scenario where your product or service saved their business.

The story of Vogmask and Rush Order is compelling, but it simply is not enough. The case study format and design attract readers' attention and make them want to know more. Rush Order uses consistent colors throughout the case study, starting with the logo, bold square blocks, pictures, and even headers.

Take a look at this product case study template below.

Just like our example, this case study template utilizes bold colors and large squares to attract and maintain the reader’s attention. It provides enough room for you to write about your customers' backgrounds/introductions, challenges, goals and results.

The right combination of shapes and colors adds a level of professionalism to this case study template.

8. AMR Hair & Beauty leverages B2B functionality to boost sales by 200%

With limits on website customization, slow page loading and multiple website crashes during peak events, it wasn't long before AMR Hair & Beauty began looking for a new e-commerce solution.

Their existing platform lacked effective search and filtering options, a seamless checkout process and the data analytics capabilities needed for informed decision-making. This led to a significant number of abandoned carts.

Upon switching to Shopify Plus, AMR immediately saw improvements in page loading speed and average session duration. They added better search and filtering options for their wholesale customers and customized their checkout process.

Due to this, AMR witnessed a 200% increase in sales and a 77% rise in B2B average order value. AMR Hair & Beauty is now poised for further expansion and growth.

This case study example showcases the power of a concise and impactful narrative.

To make their case analysis more effective, Shopify focused on the most relevant aspects of the customer's journey. While there may have been other challenges the customer faced, they only included those that directly related to their solutions.

Take a look at this case study template below. It is perfect if you want to create a concise but effective case study. Without including unnecessary details, you can outline the challenges, solutions and results your customers experienced from using your product.

Don’t forget to include a strong CTA within your case study. By incorporating a link, sidebar pop-up or an exit pop-up into your case study, you can prompt your readers and prospective clients to connect with you.

9. How a Marketing Agency Uses Visme to Create Engaging Content With Infographics

SmartBox Dental , a marketing agency specializing in dental practices, sought ways to make dental advice more interesting and easier to read. However, they lacked the design skills to do so effectively.

Visme's wide range of templates and features made it easy for the team to create high-quality content quickly and efficiently. SmartBox Dental enjoyed creating infographics in as little as 10-15 minutes, compared to one hour before Visme was implemented.

By leveraging Visme, SmartBox Dental successfully transformed dental content into a more enjoyable and informative experience for their clients' patients. Therefore enhancing its reputation as a marketing partner that goes the extra mile to deliver value to its clients.

Visme creatively incorporates testimonials In this case study example.

By showcasing infographics and designs created by their clients, they leverage the power of social proof in a visually compelling way. This way, potential customers gain immediate insight into the creative possibilities Visme offers as a design tool.

This example effectively showcases a product's versatility and impact, and we can learn a lot about writing a case study from it. Instead of focusing on one tool or feature per customer, Visme took a more comprehensive approach.

Within each section of their case study, Visme explained how a particular tool or feature played a key role in solving the customer's challenges.

For example, this case study highlighted Visme’s collaboration tool . With Visme’s tool, the SmartBox Dental content team fostered teamwork, accountability and effective supervision.

Visme also achieved a versatile case study by including relevant quotes to showcase each tool or feature. Take a look at some examples;

Visme’s collaboration tool: “We really like the collaboration tool. Being able to see what a co-worker is working on and borrow their ideas or collaborate on a project to make sure we get the best end result really helps us out.”

Visme’s library of stock photos and animated characters: “I really love the images and the look those give to an infographic. I also really like the animated little guys and the animated pictures. That’s added a lot of fun to our designs.”

Visme’s interactivity feature: “You can add URLs and phone number links directly into the infographic so they can just click and call or go to another page on the website and I really like adding those hyperlinks in.”

You can ask your customers to talk about the different products or features that helped them achieve their business success and draw quotes from each one.

10. Jasper Grows Blog Organic Sessions 810% and Blog-Attributed User Signups 400X

Jasper, an AI writing tool, lacked a scalable content strategy to drive organic traffic and user growth. They needed help creating content that converted visitors into users. Especially when a looming domain migration threatened organic traffic.

To address these challenges, Jasper partnered with Omniscient Digital. Their goal was to turn their content into a growth channel and drive organic growth. Omniscient Digital developed a full content strategy for Jasper AI, which included a content audit, competitive analysis, and keyword discovery.

Through their collaboration, Jasper’s organic blog sessions increased by 810%, despite the domain migration. They also witnessed a 400X increase in blog-attributed signups. And more importantly, the content program contributed to over $4 million in annual recurring revenue.

The combination of storytelling and video testimonials within the case study example makes this a real winner. But there’s a twist to it. Omniscient segmented the video testimonials and placed them in different sections of the case study.

Video marketing , especially in case studies, works wonders. Research shows us that 42% of people prefer video testimonials because they show real customers with real success stories. So if you haven't thought of it before, incorporate video testimonials into your case study.

Take a look at this stunning video testimonial template. With its simple design, you can input the picture, name and quote of your customer within your case study in a fun and engaging way.

Try it yourself! Customize this template with your customer’s testimonial and add it to your case study!

11. How Meliá Became One of the Most Influential Hotel Chains on Social Media

Meliá Hotels needed help managing their growing social media customer service needs. Despite having over 500 social accounts, they lacked a unified response protocol and detailed reporting. This largely hindered efficiency and brand consistency.

Meliá partnered with Hootsuite to build an in-house social customer care team. Implementing Hootsuite's tools enabled Meliá to decrease response times from 24 hours to 12.4 hours while also leveraging smart automation.

In addition to that, Meliá resolved over 133,000 conversations, booking 330 inquiries per week through Hootsuite Inbox. They significantly improved brand consistency, response time and customer satisfaction.

The need for a good case study design cannot be over-emphasized.

As soon as anyone lands on this case study example, they are mesmerized by a beautiful case study design. This alone raises the interest of readers and keeps them engaged till the end.

If you’re currently saying to yourself, “ I can write great case studies, but I don’t have the time or skill to turn it into a beautiful document.” Say no more.

Visme’s amazing AI document generator can take your text and transform it into a stunning and professional document in minutes! Not only do you save time, but you also get inspired by the design.

With Visme’s document generator, you can create PDFs, case study presentations , infographics and more!

Take a look at this case study template below. Just like our case study example, it captures readers' attention with its beautiful design. Its dynamic blend of colors and fonts helps to segment each element of the case study beautifully.

12. Tea’s Me Cafe: Tamika Catchings is Brewing Glory

Tamika's journey began when she purchased Tea's Me Cafe in 2017, saving it from closure. She recognized the potential of the cafe as a community hub and hosted regular events centered on social issues and youth empowerment.

One of Tamika’s business goals was to automate her business. She sought to streamline business processes across various aspects of her business. One of the ways she achieves this goal is through Constant Contact.

Constant Contact became an integral part of Tamika's marketing strategy. They provided an automated and centralized platform for managing email newsletters, event registrations, social media scheduling and more.

This allowed Tamika and her team to collaborate efficiently and focus on engaging with their audience. They effectively utilized features like WooCommerce integration, text-to-join and the survey builder to grow their email list, segment their audience and gather valuable feedback.

The case study example utilizes the power of storytelling to form a connection with readers. Constant Contact takes a humble approach in this case study. They spotlight their customers' efforts as the reason for their achievements and growth, establishing trust and credibility.

This case study is also visually appealing, filled with high-quality photos of their customer. While this is a great way to foster originality, it can prove challenging if your customer sends you blurry or low-quality photos.

If you find yourself in that dilemma, you can use Visme’s AI image edit tool to touch up your photos. With Visme’s AI tool, you can remove unwanted backgrounds, erase unwanted objects, unblur low-quality pictures and upscale any photo without losing the quality.

Constant Contact offers its readers various formats to engage with their case study. Including an audio podcast and PDF.

In its PDF version, Constant Contact utilized its brand colors to create a stunning case study design.  With this, they increase brand awareness and, in turn, brand recognition with anyone who comes across their case study.

With Visme’s brand wizard tool , you can seamlessly incorporate your brand assets into any design or document you create. By inputting your URL, Visme’s AI integration will take note of your brand colors, brand fonts and more and create branded templates for you automatically.

You don't need to worry about spending hours customizing templates to fit your brand anymore. You can focus on writing amazing case studies that promote your company.

13. How Breakwater Kitchens Achieved a 7% Growth in Sales With Thryv

Breakwater Kitchens struggled with managing their business operations efficiently. They spent a lot of time on manual tasks, such as scheduling appointments and managing client communication. This made it difficult for them to grow their business and provide the best possible service to their customers.

David, the owner, discovered Thryv. With Thryv, Breakwater Kitchens was able to automate many of their manual tasks. Additionally, Thryv integrated social media management. This enabled Breakwater Kitchens to deliver a consistent brand message, captivate its audience and foster online growth.

As a result, Breakwater Kitchens achieved increased efficiency, reduced missed appointments and a 7% growth in sales.

This case study example uses a concise format and strong verbs, which make it easy for readers to absorb the information.

At the top of the case study, Thryv immediately builds trust by presenting their customer's complete profile, including their name, company details and website. This allows potential customers to verify the case study's legitimacy, making them more likely to believe in Thryv's services.

However, manually copying and pasting customer information across multiple pages of your case study can be time-consuming.

To save time and effort, you can utilize Visme's dynamic field feature . Dynamic fields automatically insert reusable information into your designs.  So you don’t have to type it out multiple times.

14. Zoom’s Creative Team Saves Over 4,000 Hours With Brandfolder

Zoom experienced rapid growth with the advent of remote work and the rise of the COVID-19 pandemic. Such growth called for agility and resilience to scale through.

At the time, Zoom’s assets were disorganized which made retrieving brand information a burden. Zoom’s creative manager spent no less than 10 hours per week finding and retrieving brand assets for internal teams.

Zoom needed a more sustainable approach to organizing and retrieving brand information and came across Brandfolder. Brandfolder simplified and accelerated Zoom’s email localization and webpage development. It also enhanced the creation and storage of Zoom virtual backgrounds.

With Brandfolder, Zoom now saves 4,000+ hours every year. The company also centralized its assets in Brandfolder, which allowed 6,800+ employees and 20-30 vendors to quickly access them.

Brandfolder infused its case study with compelling data and backed it up with verifiable sources. This data-driven approach boosts credibility and increases the impact of their story.

Bradfolder's case study goes the extra mile by providing a downloadable PDF version, making it convenient for readers to access the information on their own time. Their dedication to crafting stunning visuals is evident in every aspect of the project.

From the vibrant colors to the seamless navigation, everything has been meticulously designed to leave a lasting impression on the viewer. And with clickable links that make exploring the content a breeze, the user experience is guaranteed to be nothing short of exceptional.

The thing is, your case study presentation won’t always sit on your website. There are instances where you may need to do a case study presentation for clients, partners or potential investors.

Visme has a rich library of templates you can tap into. But if you’re racing against the clock, Visme’s AI presentation maker is your best ally.

15. How Cents of Style Made $1.7M+ in Affiliate Sales with LeadDyno

Cents of Style had a successful affiliate and influencer marketing strategy. However, their existing affiliate marketing platform was not intuitive, customizable or transparent enough to meet the needs of their influencers.

Cents of Styles needed an easy-to-use affiliate marketing platform that gave them more freedom to customize their program and implement a multi-tier commission program.

After exploring their options, Cents of Style decided on LeadDyno.

LeadDyno provided more flexibility, allowing them to customize commission rates and implement their multi-tier commission structure, switching from monthly to weekly payouts.

Also, integrations with PayPal made payments smoother And features like newsletters and leaderboards added to the platform's success by keeping things transparent and engaging.

As a result, Cents of Style witnessed an impressive $1.7 million in revenue from affiliate sales with a substantial increase in web sales by 80%.

LeadDyno strategically placed a compelling CTA in the middle of their case study layout, maximizing its impact. At this point, readers are already invested in the customer's story and may be considering implementing similar strategies.

A well-placed CTA offers them a direct path to learn more and take action.

LeadDyno also utilized the power of quotes to strengthen their case study. They didn't just embed these quotes seamlessly into the text; instead, they emphasized each one with distinct blocks.

Are you looking for an easier and quicker solution to create a case study and other business documents? Try Visme's AI designer ! This powerful tool allows you to generate complete documents, such as case studies, reports, whitepapers and more, just by providing text prompts. Simply explain your requirements to the tool, and it will produce the document for you, complete with text, images, design assets and more.

Still have more questions about case studies? Let's look at some frequently asked questions.

How to Write a Case Study?

• Choose a compelling story: Not all case studies are created equal. Pick one that is relevant to your target audience and demonstrates the specific benefits of your product or service.
• Outline your case study: Create a case study outline and highlight how you will structure your case study to include the introduction, problem, solution and achievements of your customer.
• Choose a case study template: After you outline your case study, choose a case study template . Visme has stunning templates that can inspire your case study design.
• Craft a compelling headline: Include figures or percentages that draw attention to your case study.
• Work on the first draft: Your case study should be easy to read and understand. Use clear and concise language and avoid jargon.
• Include high-quality visual aids: Visuals can help to make your case study more engaging and easier to read. Consider adding high-quality photos, screenshots or videos.
• Include a relevant CTA: Tell prospective customers how to reach you for questions or sign-ups.

What Are the Stages of a Case Study?

The stages of a case study are;

• Planning & Preparation: Highlight your goals for writing the case study. Plan the case study format, length and audience you wish to target.
• Interview the Client: Reach out to the company you want to showcase and ask relevant questions about their journey and achievements.
• Revision & Editing: Review your case study and ask for feedback. Include relevant quotes and CTAs to your case study.
• Publication & Distribution: Publish and share your case study on your website, social media channels and email list!
• Marketing & Repurposing: Turn your case study into a podcast, PDF, case study presentation and more. Share these materials with your sales and marketing team.

What Are the Advantages and Disadvantages of a Case Study?

Advantages of a case study:

• Case studies showcase a specific solution and outcome for specific customer challenges.
• It attracts potential customers with similar challenges.
• It builds trust and credibility with potential customers.
• It provides an in-depth analysis of your company’s problem-solving process.

Disadvantages of a case study:

• Limited applicability. Case studies are tailored to specific cases and may not apply to other businesses.
• It relies heavily on customer cooperation and willingness to share information.
• It stands a risk of becoming outdated as industries and customer needs evolve.

What Are the Types of Case Studies?

There are 7 main types of case studies. They include;

• Illustrative case study.
• Instrumental case study.
• Intrinsic case study.
• Descriptive case study.
• Explanatory case study.
• Exploratory case study.
• Collective case study.

How Long Should a Case Study Be?

The ideal length of your case study is between 500 - 1500 words or 1-3 pages. Certain factors like your target audience, goal or the amount of detail you want to share may influence the length of your case study. This infographic has powerful tips for designing winning case studies

What Is the Difference Between a Case Study and an Example?

Case studies provide a detailed narrative of how your product or service was used to solve a problem. Examples are general illustrations and are not necessarily real-life scenarios.

Case studies are often used for marketing purposes, attracting potential customers and building trust. Examples, on the other hand, are primarily used to simplify or clarify complex concepts.

Where Can I Find Case Study Examples?

You can easily find many case study examples online and in industry publications. Many companies, including Visme, share case studies on their websites to showcase how their products or services have helped clients achieve success. You can also search online libraries and professional organizations for case studies related to your specific industry or field.

If you need professionally-designed, customizable case study templates to create your own, Visme's template library is one of the best places to look. These templates include all the essential sections of a case study and high-quality content to help you create case studies that position your business as an industry leader.

Get More Out Of Your Case Studies With Visme

Case studies are an essential tool for converting potential customers into paying customers. By following the tips in this article, you can create compelling case studies that will help you build trust, establish credibility and drive sales.

Visme can help you create stunning case studies and other relevant marketing materials. With our easy-to-use platform, interactive features and analytics tools , you can increase your content creation game in no time.

There is no limit to what you can achieve with Visme. Connect with Sales to discover how Visme can boost your business goals.

Easily create beautiful case studies and more with Visme

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10 compelling characteristics of great case studies

• TELL A STORY: Case studies stories are told to make a point or teach a lesson. They explain a journey. One that has a clear beginning and end. In this journey, the audience learns of heroes, villains, obstacles, extraordinary actions and imaginative thinking. In the end, meaningful change results.
• HAVE A LOGIC FLOW: Instead of chapters, case studies follow an outline that establishes a logic flow. The right outline is one that teachs the lesson you want the audience to learn. It can be as simple as: Situation, Solution, Results or Customer, Challenge, Journey, Discovery, Solution, Implementation, Results or one that is more customized to your desired result.
• RESOLVE A PROBLEM: The logic flow explains a problem that is resolved. At the beginning, great case studies provide perspective and context that fully explain the problem. Who is company? What do they do? What is the problem they were facing? How is this situation different for the past? Why is this relevant to your business? This establishes credibility and relevance with the audience and makes the resolution have more impact at the end.
• FOCUS ON THE CUSTOMER: The problem and the resolution always has the customer at the core, especially their relationship with the company or brand. In most cases, the company’s relationship with the customer has changed. Maybe the company stopped listening or customer needs changed or they have outgrown the product or service the company offers. But there is something that has been lost that has to found in a new way.
• PRESENT INSPIRING ACTIONS: One of the most important part of case studies is the action the company takes to overcome their problem. It should be logical but profound; smart, imaginative and showld motivate the audience to do something similar for their company.
• AVOID JARGON: Case studies should avoid terms such as “market leading” and “unique.” No one believes them. They diminish credibility and relevance.
• ARE GROUNDED IN HARD FACTS: The conclusion for all case studies is results. They should include statistics to show the difference made and benefits gained. Hard fact demonstrate how the application of the actions produced real-life results. Ballpark figures and/or indexes (if figures are confidential) are fine.
• ARE SKIMMABLE: More than one case study is generally given to make a point and teach a lesson. You may be presenting them or your audience may read them without you. Organize and write case studies so it’s easy for your audience to get the information you want them to take away.
• WORK AS SALES TOOLS: Case Studies are not about praising past work as much as courting new prospects. Whether you are responsible for the case study or merely telling the story, case studies are a reflection of the type of challenge you rise to, thinking you admire and results you recognize as important.
• HAVE A CALL-TO-ACTION: The lessons in case studies are meant to inspire others to action. It’s best to help them take the first step with a call-to-action with what you or your company offers.

If you spend any time on the  BarnRaisers website, you’ll see we are big believers in the power of case studies, In fact, we’ve written a book you invite to download our free ebook, 166 case studies prove Social Media ROI . Were these components of great case studies convincing to you? Are there any other you would include?

Rob Petersen

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Case Study Method Advantages and Disadvantages: Essential Insights for Success

Ever wondered why the case study method is so popular in fields like business, psychology, and education? It’s because case studies offer a unique way to dive deep into real-world scenarios, allowing you to explore complex issues in a detailed manner. By examining specific instances, you gain insights that are often missed in broader surveys or theoretical research.

But like any other research method, the case study approach has its pros and cons. While it provides in-depth understanding and rich qualitative data, it can also be time-consuming and sometimes lacks generalizability. So, how do you decide if it’s the right method for your research? Let’s explore the advantages and disadvantages to help you make an informed choice.

Key Takeaways

• In-Depth Insights: Case studies provide comprehensive and detailed data by exploring specific real-world scenarios, often revealing nuances and contexts missed by broader research methods.
• Qualitative and Quantitative Data: This method involves gathering a mix of qualitative and quantitative data, enhancing the richness and depth of the research.
• Challenges of Generalizability: While case studies offer in-depth insight, their findings are often specific to the case and may not be broadly applicable to other settings or situations.
• Time-Consuming Process: Conducting case studies requires significant time and effort, which can be a limitation for busy entrepreneurs and researchers needing quick insights.
• Strategic Application: Use case studies when exploring unique business models, understanding specific customer behaviors, or analyzing specific scenarios, but employ strategies like diversifying sources and effective time management to mitigate potential drawbacks.

Understanding the Case Study Method

Curious about how the case study method can enhance your entrepreneurial journey? Let’s break it down.

What Is a Case Study?

A case study is an in-depth investigation of a single entity, such as an individual, group, organization, or event. By focusing on real-life contexts, it provides comprehensive insights that can unveil unique patterns typically missed by broader research methods. This method involves a mix of qualitative and quantitative data collection techniques, including interviews, observations, and document analysis.

How Case Studies Are Used in Research

Researchers use case studies extensively across various fields due to their flexibility and depth of analysis. In business, they help you understand market trends, customer behavior, and effective strategies by examining real-life examples. Successful startups often serve as case studies, providing valuable lessons for budding entrepreneurs. In education, case studies contextualize theories, making learning more relatable. In psychology, they offer detailed explorations of specific issues or treatments, which can inform broader practices.

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Advantages of the Case Study Method

The case study method stands out in business and entrepreneurial research, offering in-depth insights and practical lessons.

In-Depth Data Collection

You gather comprehensive data through case studies, using techniques like interviews, observations, and document reviews. By employing both qualitative and quantitative methods, you gain a thorough understanding of real-world applications and business strategies. This approach lets you explore each aspect of a business scenario, providing detailed evidence for your insights.

Uncovering Nuances and Context

Case studies reveal unique patterns and hidden details often missed by broader research methods. When you analyze a successful startup, you uncover specific strategies that contributed to its success. This method helps you understand the context behind decisions, market conditions, and customer behavior, offering actionable insights for your entrepreneurial endeavors. By focusing on the nuances, you can apply these learnings to your own business and side-hustles, refining your strategies for better outcomes.

Disadvantages of the Case Study Method

Despite the many advantages, the case study method also presents several challenges that can impact its effectiveness in business contexts.

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Limitations in Generalizability

Case studies provide in-depth insights into specific scenarios; however, they often lack broad applicability. When focusing on a single business or entrepreneur, findings may not represent the experiences of others. For instance, a strategy that worked for a particular online startup might not yield the same results for a different venture due to varying market conditions and business models. Limited sample sizes in case studies further constrain their generalizability, making it difficult to formulate universal conclusions or industry-wide trends.

Time-Consuming Nature

Conducting case studies requires significant time and effort. Collecting data through interviews, observations, and document reviews can be particularly exhaustive. As an entrepreneur juggling multiple side-hustles, dedicating time to such detailed research might detract from hands-on activities that directly impact your business. Long research durations also delay the availability of insights, making them less timely or relevant in rapidly evolving market conditions. This time-intensive nature can be a deterrent, especially when quick decision-making and agility are crucial for business success.

Balancing the Pros and Cons

For entrepreneurs and business enthusiasts like you, the case study method offers a way to dive deep into specific business scenarios. It’s a powerful tool, but it has both benefits and challenges.

When to Choose Case Study Method

Use the case study method when you need detailed, practical insights. This method works well when exploring unique business models, understanding specific customer behaviors, or examining the success strategies of other startups. Large-scale statistics can’t capture the nuances you get from a focused case study.

• Launching a new product and needing to understand early adopter behavior.
• Analyzing a failed competitor to learn what went wrong.

Strategies to Mitigate Disadvantages

To mitigate the limitations of case studies, employ these strategies:

• Diversify Sources : Include multiple case studies to build a broader understanding, reducing the risk of overgeneralization.
• Time Management : Allocate specific time slots for case study research to prevent it from consuming your hands-on business activities.
• Collaborate : Work with others to share the research load and bring in diverse perspectives.

These strategies help you get the most out of the case study method while addressing common drawbacks.

The case study method offers a unique way to gain in-depth insights and analyze complex scenarios in various fields. While it has its challenges like time consumption and limited generalizability you can still leverage its strengths by using diverse sources and effective time management. Collaborating with others can also help you make the most out of your case studies. By understanding when and how to use this method you’ll be better equipped to harness its full potential for your business or research endeavors.

Frequently Asked Questions

What are the primary benefits of the case study method in business.

The case study method offers detailed insights, helps analyze market trends, and understands customer behavior through both qualitative and quantitative data collection techniques.

What fields commonly use the case study method?

The case study method is popular in business, psychology, and education for its ability to provide comprehensive and detailed insights.

What are the main disadvantages of using the case study method in business?

The main disadvantages include limitations in generalizability and the time-consuming nature of conducting in-depth research.

How can businesses mitigate the limitations of the case study method?

Businesses can mitigate limitations by diversifying their data sources, managing research time effectively, and collaborating with others to enhance the quality and applicability of their case studies.

When should entrepreneurs and business enthusiasts choose the case study method?

Entrepreneurs and business enthusiasts should choose the case study method when they need detailed, qualitative insights that cannot be captured through other research methods.

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• Open access
• Published: 12 September 2024

Clinical features, risk factors and outcomes of contact lens-related bacterial keratitis in Nottingham, UK: a 7-year study

• Lakshmi Suresh   ORCID: orcid.org/0009-0009-6204-7043 1 ,
• Yasmeen Hammoudeh 1 ,
• Charlotte S. Ho   ORCID: orcid.org/0000-0003-1131-1448 2 ,
• Zun Zheng Ong   ORCID: orcid.org/0000-0002-3091-1871 3 ,
• Jessica Cairns 1 ,
• Bhavesh P. Gopal 4 ,
• Lazar Krstic   ORCID: orcid.org/0000-0002-0305-3111 5 ,
• Ahmad Elsahn 6 ,
• Michelle M. Lister 7 ,
• Dalia G. Said 1 , 5 ,
• Harminder S. Dua 1 , 5 &
• Darren S. J. Ting   ORCID: orcid.org/0000-0003-1081-1141 1 , 8 , 9  

Eye ( 2024 ) Cite this article

5 Altmetric

Metrics details

• Corneal diseases
• Epidemiology
• Infectious diseases
• Outcomes research

Background/Objectives

To examine the clinical characteristics, risk factors and outcomes of contact lens-related bacterial keratitis (CLBK) in a large UK tertiary referral centre.

Subjects/Methods

A retrospective analysis of all patients who presented to the Queen’s Medical Centre, Nottingham, UK, with suspected CLBK between October 2015 to September 2022 (a 7-year period) was performed. Relevant data on demographic factors, CL wear behaviour, causes, clinical characteristics, and outcomes were analysed.

We included 138 patients with CLBK; the mean age was 42.0 ± 17.8 years and 74 (53.6%) patients were male. Most CLBK were related to soft CL wear (94.5%), particularly monthly disposable (42.5%) and daily disposable (24.4%) CLs. Poor CL wear behaviour/hygiene was documented in 57.1% cases. Among the 64 (46.4%) microbiological-positive cases (n = 73 organisms), Pseudomonas aeruginosa (36, 49.3%) and Staphylococcus spp . (16, 21.9%) were most commonly identified. Six (4.3%) cases were polymicrobial. Most (97.0%) patients were successfully treated with topical antibiotics alone, with 80.6% achieving good final corrected-distance-visual-acuity (CDVA) of ≥ 0.30 logMAR. Poor visual outcome (final CDVA < 0.30 logMAR) was significantly associated with presenting CDVA < 0.6 logMAR ( p  = 0.002) and central ulcer ( p  = 0.004). Poor corneal healing (complete healing of > 30 days from initial presentation) was significantly associated with age > 50 years ( p  = 0.028), female gender ( p  = 0.020), and infiltrate size >3 mm ( p  = 0.031).

Conclusions

Poor CL wear behaviour/hygiene is commonly observed in CLBK, highlighting the importance of improved counselling and awareness regarding CL use and hygiene. When presented early and managed appropriately, most patients are able to achieve good clinical outcomes with medical treatment alone.

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Acanthamoeba keratitis in Australia: demographics, associated factors, presentation and outcomes: a 15-year case review

Predisposing factors, microbiological features and outcomes of patients with clinical presumed concomitant microbial and herpes simplex keratitis

Introduction.

Infectious keratitis (IK) represents the leading cause of corneal blindness worldwide [ 1 , 2 ]. Global incidence of IK has been estimated at approximately 2.5 to 799 cases per 100,000 population/year, with a considerably higher incidence in the low- and middle-income countries (LMICs). It is a painful and potentially sight-threatening ocular disease that often requires intensive treatment and/or hospitalisation, posing significant impact on patients’ quality of life, healthcare systems, and economy [ 3 ].

IK can be caused by a wide range of pathogens, including bacteria, fungi, protozoa, and viruses. Bacterial keratitis (BK) has been consistently shown to be the most common cause of microbial keratitis (i.e., bacterial, fungal, and protozoan keratitis) in developed countries, including the UK, accounting for > 90% of all cases of microbial keratitis in some studies [ 4 , 5 ]. The innate defence mechanisms at the ocular surface ensure that IK rarely occurs without any predisposing factor [ 2 , 6 , 7 ]. Among all, contact lens (CL) wear is recognised as one of the main risk factors for BK [ 7 , 8 , 9 , 10 ]. Some studies have highlighted ~10-80 times increased risk of developing IK in CL wearers compared to healthy non-CL wearers [ 11 , 12 ]. This has a significant implication on global health as the number of contact lens wearers has been estimated at 140 million worldwide and is likely to increase in the coming decades [ 13 ].

CL-related IK tends to affect younger patients and working adults more commonly due to their higher social and occupational needs for CL [ 8 , 14 ]. This could have a considerably negative effect on work productivity and economy as a result of lost working days. CL-related IK is most commonly caused by Pseudomonas aeruginosa , likely attributed to its ability to survive in contact lens solution and ocular environment and to form biofilm on CL [ 8 , 9 , 15 ]. Several risk factors associated with CL-related IK have been highlighted; these included CL material and design, overnight wear, showering/swimming with CL use, and poor hygiene, amongst others [ 16 , 17 , 18 ].

Despite the prevalent number of CL wearers and the potential impact of CL-related IK, there was no study in the past decade that had specifically evaluated the clinical characteristics and outcomes of CLBK in the UK. In view of the gap in the literature, this study aimed to provide an up-to-date analysis of CL-related BK (CLBK) in a major tertiary ophthalmic referral centre in the UK.

Materials and methods

This was a retrospective study which captured all patients who had presented to Queen’s Medical Centre, Nottingham, UK between October 2015 and September 2022 (a 7-year period) with suspected CLBK bacterial keratitis and underwent corneal sampling. The study was approved as a clinical audit by the Clinical Governance team at the Nottingham University Hospitals NHS Trust (Ref: 19–265C) and was conducted in accordance with the tenets of Declaration of Helsinki.

Case identification, inclusion and exclusion

Potential eligible patients were first identified through the local microbiology database [ 8 , 19 ]. Both microbiological-positive and microbiological-negative presumed CLBK cases were included. Microbiological-positive cases were defined by the presence of clinical characteristics of BK (e.g., corneal epithelial defect, infiltrate, and anterior chamber activity) with microbiological confirmation of bacterial organism(s) from corneal sampling. Microbiological-negative cases were defined by the presence of clinical characteristics of BK in the absence of positive microbiological result and was treated with intensive topical antibiotic treatment alone (but no other antimicrobial treatment). Exclusion criteria included cases that were not related to CL wear, non-bacterial related or mixed infections (i.e. mixed bacterial, fungal and/or Acanthamoeba infections).

Data collection

Relevant data regarding demographic factors, risk factors, presenting features, corrected-distance-visual-acuity (CDVA), causative organisms, treatment, and outcomes were collected from local electronic health record systems using a standardised excel proforma. Details on CL wear included the type of CL worn (e.g. daily/monthly disposable soft CL, extended wear soft CL, rigid gas permeable (RGP) CL, therapeutic bandage CL, and cosmetic CL), overnight wear, contact with water (e.g. showering or swimming with CL wear), and frequency/duration of wear. Extended wear was referred to the CL type that were designed to be worn continuously, including overnight, whereas overnight wear was referred to the behavioural use of CL overnight (irrespective of whether the CL was designed as extended wear or not). The size of epithelial defect and infiltrate was defined by the maximal linear dimension of the ulcer and was divided into 3 categories: (1) small ( < 3.0 mm); (2) moderate (3.1–6 mm); and (3) large ( > 6.0 mm) [ 8 ]. The location of ulcer was defined as: (1) peripheral: ulcer located fully within 3 mm of the limbus; (2) paracentral: any part of the ulcer involving the paracentral cornea ( > 3 mm from the limbus) but not affecting the visual axis; and (3) central: any part of the ulcer affecting the visual axis.

Microbiological investigations

All patients who presented with suspected CLBK with any of the following clinical characteristics, including (1) ulcer of >1 mm diameter, (2) central location, (3) presence of anterior chamber activity and/or hypopyon, and/or (4) atypical clinical presentation, underwent corneal sampling as per the departmental guideline [ 8 ]. Corneal samples were sent for microscopic examination, microbiological culture and susceptibility testing, and/or 16S/18S polymerase chain reaction (PCR; only introduced since June 2021) [ 20 ]. CL and CL solution were not routinely sent for culture, and therefore the results were not included in the analysis. Cultures were inoculated on chocolate, blood, fastidious anaerobic, and Sabouraud dextrose agars to isolate bacterial and fungal organisms. For suspected Acanthamoeba keratitis, corneal sampling was performed for either culture (using non-nutrient agar with Escherichia coli overlay) or PCR [ 21 ]. However, as stated, fungal and Acanthamoeba positive cases were excluded from this study.

Clinical management

All patients were started on intensive topical antibiotics with either fluoroquinolone monotherapy (levofloxacin 0.5% or moxifloxacin 0.5%) or dual therapy using fortified cefuroxime 5% plus fortified aminoglycoside (e.g., amikacin 2.5% or gentamicin 1.5%) or levofloxacin 0.5%. Topical antibiotics were given every hourly for first 48 h then slowly tapered off over a few weeks-months, depending on the treatment response and clinical progress. Adjustments to treatment were made (if necessary) depending on the microbiological results and clinical response to treatment. Hospitalisation was indicated in moderate/severe or potentially sight-threatening cases, presence of considerable corneal melt or threatened/actual corneal perforation, or patients who might not manage or comply with treatment at home [ 8 ]. Systemic antibiotic was administered if there was risk or evidence of sclerokeratitis or intraocular involvement such as endophthalmitis (which would also require intravitreal antibiotics).

Statistical analysis

Statistical analysis was performed using SPSS software version 28.0 (IBM Corp; Armonk, NY, USA). For descriptive and analytic purposes, cases were divided into microbiological-positive and microbiological-negative cases. Chi square test or Fisher’s Exact test was used to analyse the difference between categorical variables whereas Student’s T-test or Mann-Whitney U-test was used to compare the means between two groups where appropriate. CDVA was recorded and analysed in logMAR unit. CDVA of counting fingers, hand movement, perception of light, and no perception of light were converted to 1.9, 2.3, 2.8, and 3.0 logMAR, respectively [ 22 ]. Multivariable logistic regression analysis was conducted to examine for any prognostic factors for poor visual outcome (defined as a final CDVA < 0.30 logMAR) and poor corneal healing (defined as > 30 days for complete corneal healing). Odds ratios (OR) were calculated and presented with a 95% confidence interval (CI). P -value of < 0.05 was considered statistically significant.

A total of 138 patients ( n  = 138 eyes) were included. Patients’ mean age was 42.0 ± 17.8 years, with 120 (87.0%) being of working age (i.e. 16–64 years old) and 74 (53.6%) being male (Table  1 ). No bilateral cases were identified. The mean follow-up duration was 2.9 ± 5.3 months. Of all cases, 64 (46.4%) were microbiological-positive.

Clinical features, causative organisms and antimicrobial susceptibility results

The baseline clinical characteristics are presented in Table  1 . The mean duration of symptoms prior to presentation was 3.3 ± 5.8 days. The majority of the patients presented with a CDVA of ≥0.30 logMAR (i.e., 6/12 or better Snellen vision; 59, 42.8%) and an ulcer with small epithelial defect (106, 76.8%), small infiltrate (116, 84.1%), paracentral location (74, 53.6%), and absence of hypopyon (104, 75.4%). When comparing microbiological-positive and microbiological-negative cases, microbiological-positive cases had a worse presenting CDVA, larger epithelial defect and infiltrate, and higher proportion of hypopyon (all p  < 0.05; Table  1 ).

Of the 64 microbiological-positive cases, 63 cases were culture-positive (including one case of smear-positive case) and one case was culture-negative but PCR-positive (which identified P. aeruginosa and Abiotrophia defective ). Of all 73 bacteria isolated, P. aeruginosa (36, 49.3%) and Staphylococcus spp . (16, 21.9%) were the most common bacteria (Table  2 ). There were six (4.3%) cases of polymicrobial infection (i.e. infection caused by more than one bacterial species) identified. Gram-positive bacteria demonstrated excellent susceptibility to vancomycin (100%) and aminoglycosides (94.1%–100%), and moderate-to-good susceptibility to penicillin (84.6%) and fluoroquinolones (50%–77.8%). Gram-negative bacteria exhibited excellent susceptibility to aminoglycosides (95.2%–100%) and moderate-to-good susceptibility to fluoroquinolones (75%) and cefuroxime (60.0%; Supplementary Table  1 ).

Details of contact lens wear and risk factors

Details of CL wear, including the types of CL and behavioural risk factors, are detailed in Table  3 . Based on the available information, the most common type of CL was monthly disposable refractive CL (56, 40.6%) followed by daily disposable refractive correcting lenses (30, 21.7%). A small number of cases were related to the use of RGP CL (7, 5.5%), therapeutic/bandage CL (3, 2.4%), and cosmetic CL (1, 0.9%). None of the cases was related to orthokeratology RGP CL. There was a lack of information on the types of CL material as these data were not routinely recorded in medical case notes.

Of the 119 patients with details of CL wear, 68 (57.1%) patients were noted to have at least one behavioural risk factor, including overnight wear (43, 36.1%), contact with water (59, 49.6%) and long duration of CL wear ( > 16 hours/day; 26/95, 27.4%). In addition to CL wear, 41 (29.7%) cases had at least one additional risk factor, including ocular surface disease (32, 23.2%), systemic immunosuppression/diabetes (10, 7.2%), trauma (9, 6.5%), previous corneal graft (5, 3.6%), and concomitant use of topical steroids (5, 3.6 %) .

Clinical management and outcomes

Full follow-up details were available for 134 (97.1%) patients. The majority (130, 97.0%) of patients were successfully treated with intensive topical antibiotics alone, including levofloxacin / moxifloxacin monotherapy (65, 48.5%) and dual therapy (69, 51.5%), consisting of cefuroxime in combination with amikacin, gentamicin, or levofloxacin. Topical steroids were used in 55 (41.0%) cases, with a mean start time of 11.1 ± 11.6 days after the initial presentation. Topical steroids were used in both microbiological-positive (31, 50%) and microbiological-negative (24, 33.3%) cases for a mean duration of 23.6 ± 20.3 days, after excluding cases that required long-term topical steroid use (e.g. eyes with previous keratoplasty) from the analysis. Hospitalisation for intensive treatment was warranted in 52 (37.7%) patients, with microbiological-positive cases having a greater need and longer duration of hospitalisation (p < 0.01) (Table  1 ). Three (2.2%) patients underwent optical penetrating keratoplasty for treating post-infection corneal scar and one (0.7%) patient required amniotic membrane grafting for managing persistent corneal epithelial defect. Recurrence of infection and corneal melt were noted in 11 (8.2%) and 6 (4.5%) cases, respectively, but were successfully managed with topical antibiotics. No significant adverse event, such as corneal perforation or uncontrollable infection requiring therapeutic keratoplasty or anophthalmic surgery, was noted.

Of the 134 patients, the mean CDVA improved significantly from 0.70 ± 0.76 logMAR at presentation to 0.21 ± 0.40 logMAR at final follow-up ( p  < 0.001), with 114 (85.1%) patients achieving an equal or better final CDVA compared to the initial CDVA (Fig.  1 ). The proportion of patients with CDVA of ≥ 0.30 logMAR increased from 42.5% to 80.6% ( p  < 0.001). The mean complete corneal healing time was 21.4 ± 15.2 days, with 31 (23.1%) cases having a delayed corneal healing (i.e. > 30 days).

A scatterplot demonstrating the corrected-distance-visual-acuity (CDVA) of CLBK at initial presentation and final follow-up visit. The dotted red line (x = y) represents no change in the visual acuity. The points located below or above the dotted red line represent an improvement or decrease in the final CDVA, respectively, when compared to the initial CDVA.

Prognostic factors

Multivariable logistic regression analysis demonstrated that poor visual outcome was significantly influenced by presenting CDVA < 0.6 logMAR [OR 5.63 (95% CI, 1.85–17.17); p  = 0.002] and centrally located ulcer [OR 4.53 (95% CI, 1.62–12.71); p  = 0.004] (Table  4 ). Poor corneal healing time was significantly associated with age >50 years [OR 2.85 (95% CI, 1.12–7.25); p  = 0.028], female gender [OR 3.08 (95% CI, 1.19–7.94); p  = 0.020], and infiltrate >3 mm diameter [OR 3.53 (95% CI, 1.12–11.09); p  = 0.031]. Other factors such as eye laterality, presence of hypopyon and positive microbiological results did not significantly affect the visual outcome or corneal healing time (all p  > 0.05).

CL wear represents one of the most common risk factors for IK in developed countries, accounting for 30–65% of all IK cases [ 1 , 7 , 8 ]. The incidence of CL-related IK was estimated at 10–130 per 100,000 people-year, highlighting its potential burden on global health and economy [ 1 , 11 , 23 ]. To the best of our knowledge, this study represents the largest UK study that had specifically examined the clinical characteristics, risk factors, causes, and outcomes of CLBK over the past decade.

Demographic and risk factors

Majority (87%) of our patients were of working adult age, which was similarly observed in other studies (usually ~25–55 years old) [ 1 , 8 , 16 , 24 , 25 ]. Some studies have identified an increase in incidence of CL-related IK in younger patients ( ~ 20–30 years old), potentially related to poorer CL hygiene and use of cosmetic CLs [ 17 , 26 ]. A range of modifiable risk factors have previously reported, including extended wear, overnight wear, contact with water, poor CL storage case hygiene/care, and poor hand hygiene. [ 16 , 17 , 18 , 23 , 24 ] In our study, we noted poor CL wear behaviours/hygiene such as overnight wear, extended wear and contact with water in > 50% of our patients, and this figure may be potentially underestimated due to possible under-recording in clinical notes. Furthermore, the type of CL serves as another significant influencing factor for CL-related IK [ 12 , 18 , 23 ]. Extended wear soft CL has been shown to have the highest risk of CL-related IK, followed by daily soft CL (non-extended wear) and rigid gas-permeable CL [ 15 , 23 , 24 , 27 , 28 ]. Our study showed that monthly disposable CL was the most common type (42.5%) of CL whereas extended wear CL was the least common choice (7.1%). In view of the low number of CLBK cases associated with extended overnight wear CL (despite its inherent higher risk of causing infection), one may infer a reducing trend in the use of extended overnight wear CL in this UK population. While all these risk factors increase the risk of CLBK, we did not observe any significant influence of these risk factors on microbiological positivity.

Clinical features and causative organisms

Majority of our cases were of mild severity (84% with < 3 mm infiltrate), which might be attributed to the early presentation to the hospital (the mean duration of symptoms before presentation was 3.3 days). This has significant clinical implications as visual outcome of IK, including CLBK, is highly dependent on timely diagnosis and treatment [ 8 , 29 ]. The relatively mild severity of infection may also be attributed to the low proportion ( < 10%) of extended wear CL in our cohort. Extended wear CL can increase the retention time and growth of the organisms on the ocular surface, resulting in more severe infection, as opposed to daily replacement of CL [ 24 ]. We also observed that microbiological positivity was correlated with the severity of infection, which was similarly observed in previous studies [ 8 , 30 ]. In contrast, a US study conducted more than a decade ago reported that a considerably higher proportion of CLBK patients presented with more severe infection, with an ulcer > 4 mm in size (46%) and hypopyon (36%) [ 31 ]. The disparity in severity may be related to the difference in the proportion of cases affected by P. aeruginosa (63% in the US study), ocular co-morbidities, and/or time interval between onset of symptoms and presentation to the hospital.

P. aeruginosa (49.3%) and Staphylococcus spp . (21.9%) were shown to be the most common organisms in our study, paralleling the findings of many other studies [ 9 , 16 , 24 , 28 , 31 ]. However, a study conducted in South India identified Serratia spp . as the most common organism for CLBK, whereas a Japanese study reported Staphylococcus epidermidis as the most common causative organism [ 9 , 25 ]. Such heterogeneity highlights the geographical and temporal variations of the disease and the importance of up-to-date regional analysis of the causative organisms (as it may serve as a useful guide for treatment, particularly when the microbiological result is negative).

Clinical and visual outcomes

The majority (97.0%) of our patients were successfully managed with topical antibiotics alone (without systemic antibiotic or surgical intervention), with 80.6% achieving a final CDVA of ≥ 0.30 logMAR. Enzor et al. [ 32 ] reported a slightly higher rate of surgical intervention (14%) for their patients with CLBK. However, they only included cases affected by P. aeruginosa , which is notoriously known to cause severe corneal infection, stromalysis and visual loss [ 9 , 28 , 32 ]. Nonetheless, CLBK has been shown to have a better visual outcome than non-CLBK [ 32 ]. This may be attributed to a younger age, less ocular/systemic comorbidities and earlier presentation of the disease in patients with CLBK (as CL wearers may be more aware/concern of any new ocular symptoms that can interfere with their CL wear). Indeed, when compared to our previous BK study (which included 65% non-CLBK and 35% CLBK) [ 8 ], the mean duration of symptoms prior to presentation was 5.3 days in the previous study (as opposed to 3.3 days in this study), suggesting that CL wearers are more likely to seek earlier medical attention. In addition, 35% of the patients in the previous study had more severe infection at presentation than this study (35% vs. 16% with ulcers of >3 mm infiltrate).

We also observed that poor visual outcome was significantly associated with poorer presenting CDVA and central ulcer. These findings were similarly observed in other CLBK studies conducted in France and the US [ 10 , 32 ], highlighting the importance of prompt diagnosis and treatment in CLBK and IK in general [ 16 ]. Furthermore, we found that corneal healing was negatively correlated with increased age and larger infiltrate size. Increased cell senescence in ageing cornea may affect the epithelial adhesion molecules function, phagocytic ability of reactive polymorphonuclear cells, and the innate and/or adaptive immune responses at the ocular surface, resulting in slower eradication of infection and delayed corneal healing [ 33 ]. In addition, older patients generally have multiple ocular/systemic co-morbidities (e.g. ocular surface diseases, diabetes, previous corneal surgeries, etc.), which can contribute to poor wound healing. Interestingly, female gender was associated with poorer corneal healing, which contrasted the findings observed by Das et al. [ 25 ] and Konda et al. [ 27 ]. While sex-specific difference in corneal healing has been shown in mice studies (with female mice corneas having a slower healing rate due to the effect of oestradiol) [ 34 ], this observation has not been supported by other preclinical or human corneal studies [ 35 ]. Our finding may be confounded by other variables (e.g., difference in types and severity of co-morbidities) and requires further elucidation.

While we found that microbiological positivity was associated with more severe infection, it did not influence the visual outcome or the corneal healing time, similarly observed in other studies [ 31 , 36 ]. One plausible explanation is the ability to initiate/administer the optimal antibiotic therapy based on the positive microbiological and susceptibility/resistance results, thereby achieving a similarly good outcome as microbiological-negative cases. In addition, a significantly higher proportion of patients with microbiological-positive CLBK were hospitalised for intensive treatment and monitoring (for a longer duration), which might have contributed to the good clinical recovery and outcomes. Reassuringly, only a few patients required surgical interventions, including amniotic membrane grafting, which has been shown to expedite corneal healing in bacterial keratitis [ 37 ].

Study limitations

One of our study limitations is that we only included cases that had undergone corneal sampling; hence some of the very mild CLBK cases (i.e. small ( < 1 mm), non-sight-threatening ulcer) might not have been captured by this study. However, these very mild cases usually have less impact on the patients and are responsive to topical antibiotics; if not, the affected patients would re-present to our unit for further management (which would include corneal sampling and be included in our study). Another limitation is the inclusion of microbiological-negative CLBK cases. However, all cases were only included after careful analysis of patients’ case notes to confirm eligibility. In addition, microbiological-negative cases represent >50% of all IK cases in the real-world setting in many regions, including the UK [ 5 , 19 ]. Therefore, a good understanding of the clinical characteristics, management and outcomes of microbiological-negative cases are invaluable for clinicians and patients. Implementation of molecular diagnostics and next-generation sequencing may potentially ameliorate the low culture yield in the future [ 38 , 39 , 40 ]. As this study was not a case-control study, we could not ascertain the relative/absolute risk difference of CLBK among each CL type. It would also be interesting to analyse the impact of CL material on the clinical characteristics of CLBK as it has been shown to influence the severity of infection [ 18 ], though these data were not routinely collected in daily clinical practice. Nonetheless, we observed that 57% of our patients reported poor CL hygiene, and this figure might be underestimated as these risk factors might be under-recorded in medical notes.

In conclusion, CLBK represents as a significant ocular condition that can have a negative impact on patient’s vision, quality of life, healthcare resources, and work productivity (as affected patients are usually of working age). Timely presentation, diagnosis and treatment is key to achieving a good outcome. Poor CL behavioural risk factors are commonly observed among our patients, highlighting the need for improved education and awareness of CL care/hygiene.

What was known before

Contact lens (CL) wear is a major risk factor for bacterial keratitis.

Poor CL wear behaviour/hygiene increases the risk of CL-related bacterial keratitis (CLBK).

There is no study in the UK that had specifically analysed the risk factors, causes and outcomes of CLBK in the past decade.

What this study adds

This study provides one of the most comprehensive and up-to-date analyses of CLBK in the UK in the past decade.

With prompt diagnosis and treatment, most patients with CLBK can be successfully treated with intensive topical antibiotics alone and achieve a good outcome.

Microbiological positivity is significantly associated with the initial severity of CLBK but has no significant influence on the final visual outcome or corneal healing time.

Data availability

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

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Acknowledgements

Funding/Support: DSJT acknowledges support from the Birmingham Health Partners (BHP) Clinician Scientist Fellowship, the Medical Research Council / Fight for Sight Clinical Research Fellowship (MR/T001674/1), and the FFS / John Lee, Royal College of Ophthalmologists Primer Fellowship (24CO4).

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Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham, UK

Lakshmi Suresh, Yasmeen Hammoudeh, Jessica Cairns, Dalia G. Said, Harminder S. Dua & Darren S. J. Ting

Department of Ophthalmology, Western Eye Hospital, London, UK

Charlotte S. Ho

New Cross Eye Hospital, Wolverhampton, UK

Zun Zheng Ong

Department of Ophthalmology, Luton Hospital, Luton, UK

Bhavesh P. Gopal

Department of Ophthalmology, Queen’s Medical Centre, Nottingham, UK

Lazar Krstic, Dalia G. Said & Harminder S. Dua

Department of Ophthalmology, King’s Mill Hospital, Sherwood Forest Hospitals NHS Foundation, Sutton-in-Ashfield, UK

Ahmad Elsahn

Department of Microbiology, Queen’s Medical Centre, Nottingham, UK

Michelle M. Lister

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Study conceptualisation and design: DSJT; Data collection: LS, YH, CSH, ZZO, JC, BPG, LK, AE, MML; Data analysis: LS, DSJT; Data interpretation: LS, DGS, HSD, DSJT; Drafting of initial manuscript: LS, DSJT; Critical revision and approval of final manuscript: All authors; Study supervision: DSJT

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Suresh, L., Hammoudeh, Y., Ho, C.S. et al. Clinical features, risk factors and outcomes of contact lens-related bacterial keratitis in Nottingham, UK: a 7-year study. Eye (2024). https://doi.org/10.1038/s41433-024-03323-7

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Spontaneous rupture and hemorrhage of renal epithelioid angiomyolipoma misdiagnosed to renal carcinoma: a case report

• Wenhao Zhang 1 ,
• Xiaodong Jin 1 ,
• Chundan Wang 2 ,
• Shaobo Jiang 1 ,
• Jiasheng Yan 1 &
• Yubing Li 1  

Journal of Medical Case Reports volume  18 , Article number:  425 ( 2024 ) Cite this article

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Renal epithelioid angiomyolipoma is a rare and unique subtype of classic angiomyolipoma, characterized by the presence of epithelioid cells. It often presents with nonspecific symptoms and can be easily misdiagnosed due to its similarity to renal cell carcinoma and classic angiomyolipoma in clinical and radiological features. This case report is significant for its demonstration of the challenges in diagnosing epithelioid angiomyolipoma and its emphasis on the importance of accurate differentiation from renal cell carcinoma and classic angiomyolipoma.

Case presentation

A 58-year-old Asian female presented with sudden left flank pain and was initially diagnosed with a malignant renal tumor based on imaging studies. She underwent laparoscopic radical nephrectomy, and postoperative histopathology confirmed the diagnosis of epithelioid angiomyolipoma. The patient recovered well and is currently in good health with regular follow-ups. This case highlights the diagnostic challenges, with a focus on the clinical, radiological, and histopathological features that eventually led to the identification of epithelioid angiomyolipoma.

Conclusions

Epithelioid angiomyolipoma is easily misdiagnosed in clinical work. When dealing with these patients, it is necessary to make a comprehensive diagnosis based on clinical symptoms, imaging manifestations, and pathological characteristics.

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Introduction

Renal epithelioid angiomyolipoma (EAML) is a special subtype of classic angiomyolipoma (CAML), which comprises vascular (angio-), smooth muscle (-myo-), and adipose (-lipoma) components [ 1 ]. Unlike the classical form, EAML is predominantly characterized by the presence of epithelioid cells [ 2 ].

EAML exhibits nonspecific symptoms, including abdominal pain, abdominal mass, and hematuria, or may be asymptomatic [ 3 ]. Imaging studies typically demonstrate characteristic features due to the presence of adipose tissue. However, a few atypical renal hamartomas might lack detectable adipose components on imaging, leading to misdiagnosis as RCC or CAML. Such EAML presentations often manifest as renal parenchymal masses. Due to the lack of effective diagnostic and differentiation criteria, precise diagnosis of these cases poses a significant challenge for urological clinicians [ 4 ].

In this particular patient, we mistakenly diagnosed a ruptured and bleeding EAML as a malignant renal tumor, resulting in radical nephrectomy. Subsequent postoperative histopathology confirmed the infiltrative growth pattern and low-grade malignant nature of the EAML.

This case report aims to emphasize the clinical, radiological, and histopathological features contributing to EAML and differentiate it from RCC and CAML. Furthermore, we summarize the current worldwide scholars’ comprehensive diagnostic approaches (including imaging modalities and histological assessments) to guide appropriate management decisions and optimize patient outcomes.

The patient, a 58-year-old Asian female, was admitted due to “sudden left flank pain for one day.” The patient experienced sudden and severe pain after squatting, which persisted and was unrelieved. There was no fever, hematuria, diarrhea, nausea, or vomiting. The patient had not had similar symptoms before. Then, the patient sought medical attention at a local hospital, where an abdominal computed tomography (CT) revealed a nodular lesion in the lower pole of the left kidney with a high-density subcapsular shadow, suggesting malignant renal tumor with bleeding and left renal vein tumor thrombus formation. The local hospital provided symptomatic treatment including antispasmodic and analgesic treatments. The patient’s symptoms were better than before. Subsequently, the patient was referred to our hospital for further treatment. The patient was transported to our hospital on the same day with the initial diagnosis of ‘“left malignant renal tumor.” Then she was immediately admitted for management. Physical examination indicated stable vital signs, with no abnormalities in the cardiovascular and respiratory systems. Abdominal and limb examinations showed no peculiarities, but there was positive tenderness in the left renal area. Relevant preoperative investigations showed the following results. Hematology revealed anemia with normal white blood cell count and elevated hypersensitive C-reactive protein. Biochemistry showed reduced potassium, calcium, total protein, and albumin levels, elevated homocysteine and serum amyloid A protein levels, and increased sialic acid. CT scan revealed an occupying lesion in the lower pole of the left kidney, possibly renal cancer, left renal subcapsular hematoma, right renal cyst, and normal renal artery on computed tomography angiography (CTA) (Fig.  1 ). Magnetic resonance imaging (MRI) showed a lesion in the lower pole of the left kidney with heterogeneous signal, possibly renal cancer with bleeding (Fig.  2 ). Electron capture tomography (ECT) demonstrated reduced left kidney function and normal right kidney function. Combined with the patient’s symptoms and auxiliary examination results, all evidence points to the patient’s diagnosis of renal tumor. The final diagnosis was a “left malignant renal tumor with bleeding and left renal vein tumor thrombus formation and left renal dysfunction.”

Computed tomography angiography findings of the epithelioid angiomyolipoma

Magnetic resonance imaging (MRI) findings of the epithelioid angiomyolipoma

After completing preoperative preparations, the patient underwent laparoscopic radical nephrectomy for renal cancer, with a smooth surgical procedure. We dissected the resected kidney after surgery and clearly saw the tumor and perirenal hemorrhage (Fig.  3 ). Postoperative pathology (Fig.  4 ) revealed “renal epithelioid angiomyolipoma” on the lower pole of the left kidney, presenting as a mass measuring 2.5  ×  2.5 × 2 cm. Microscopic examination showed tumor cells with pleomorphic and spindle shapes, displaying cellular atypia, occasional multinucleated giant cells, rare mitotic figures, and acidophilic cytoplasm, and arranged in a sheet-like pattern. The tumor exhibited infiltrative growth with intravascular tumor thrombi, negative resection margins on the renal hilum and the ureter. Immunohistochemistry staining results indicated Ki-67 (5%+), P53 (occasional+), CK7 (−), CD10 (−), P504S (−), CK34βE12 (−), RCC (−), TFE3 (−), CAIX (−), Vim (+), CD34 (endothelial+), E-cad (+), EMA (−), PAX-8 (−), HMB-45 (+), MelanA (+), CAM5.2 (−), and D2-40 (lymphatic vessels+). After surgery, the patient experienced no complications during the postoperative recovery period and was discharged 1 week after surgery. The patient is currently in good health and is regularly followed up with the outpatient department of our hospital.

Postoperative specimen

Histopathological image of the epithelioid angiomyolipoma. A ×4, B ×40

EAML is a unique subtype of angiomyolipoma, characterized by the presence of various cytoplasm-rich, acidophilic epithelioid cells, in addition to mature adipose cells, thick-walled vessels, and smooth muscle-like spindle cells [ 5 ]. EAML is a rare renal epithelial tumor, accounting for less than 1% of all renal epithelial tumors and approximately 7.7% of renal angiomyolipoma [ 6 ]. Previous literature reports indicate that EAML can exhibit invasive growth, recurrence, metastasis and intravascular tumor thrombi [ 7 ], rendering it a potentially malignant tumor with a metastatic rate of about one-third [ 8 ]. In our case, as a potentially malignant tumor, EAML demonstrated its invasiveness into surrounding tissues. When the patient experienced severe lumbar pain, CT results showed a local filling defect in the renal vein, indicating vascular invasion by the tumor. In recent years, due to the lack of typical clinical and radiological features, preoperative accurate diagnosis of EAML is challenging, leading to misdiagnosis and missed diagnosis. Currently, the definitive diagnosis mainly relies on postoperative histopathological examination. Although advances have been made in pathological diagnosis techniques, comprehensive understanding of EAML among clinical practitioners remains lacking. Therefore, we report this patient, which is the first case report on the whole network in which a ruptured and bleeding renal epithelioid angiomyolipoma was misdiagnosed as kidney cancer. We published our diagnosis and treatment process to remind colleagues to pay attention to such cases. Our case report, combined with other studies, will aid in comprehensively summarizing the diagnosis and treatment norms of EAML.

Based on our patient and extensive literature review, we summarize the clinical characteristics of EAML. In the early stages of the disease, EAML often lacks specific clinical symptoms and is usually incidentally detected during physical examinations or follow-up of patients with tuberous sclerosis complex (TSC) [ 9 ]. As the tumor enlarges, patients may experience localized discomfort due to traction on the renal capsule, presenting clinical symptoms such as lumbar pain, abdominal pain, and abdominal mass. Further progression of the tumor, involving adjacent blood vessels or causing ruptured hemorrhage, can lead to sudden severe pain and hematuria [ 10 ]. When a patient with a renal mass experiences acute bleeding, clinical practitioners should consider EAML in the diagnostic process.

The imaging features of EAML often resemble those of RCC or CAML. The lack or minimal presence of adipose tissue on imaging is one of the important reasons for misdiagnosis [ 11 ]. Previous studies have shown that EAML typically appears as a high-density solid lesion on CT, and its extrarenal growth often leads to changes in the renal contour. Most lesions have a smooth interface with the renal parenchyma, forming the “cup sign” or “split sign” [ 12 ]. The patient’s CT coronal image showed a clear “cup sign.” In MRI images, the solid components of EAML usually present as low signals on T2-weighted images [ 13 ]. One-third of EAML cases may also exhibit malignant behavior on MRI, such as local invasion and distant metastasis. The renal capsule, perirenal fat, and renal vein are the most susceptible tissues to invasion [ 14 ]. The identification of such features on MRI should prompt consideration of EAML in the diagnosis. In recent years, deep learning has introduced many new methods to address various computer vision problems [ 15 ]. Many medical imaging problems have also adopted deep neural network structures, achieving excellent results [ 16 ]. From our perspective, collecting sufficient EAML imaging data and using residual neural networks and dilated convolutions for network training and local prediction may enable the discovery of new features for precise EAML diagnosis that cannot be discerned by the naked eye.

Due to the lack of specific clinical manifestations and radiological features, EAML is often prone to misdiagnosis in clinical practice. Histopathological examination of tumor tissues remains an essential means for confirming the diagnosis. On cytological morphology, Caliò summarized two presentations of EAML under the microscope. One of the presentations is EAML consisting of atypical large acidophilic cells with prominent nuclei, exhibiting a cancer-like appearance. The intranuclear inclusions are often present (neuroblastoma-like appearance) and arranged together. Multinucleated giant cells can resemble the atypical mononuclear cells in the background and may display areas of necrosis. The other presentation comprises epithelioid and enlarged spindle cells, arranged diffusely. Compared with cancerous tumors, these tumors show uniform growth patterns, less cellular atypia, clearer cytoplasm, and intranuclear inclusions [ 17 ]. Additionally, the mesenchymal component of EAML primarily exhibits large acidophilic pleomorphic cells with prominent nucleoli, while the CAML show more bland spindled cells. The presence of atypical mitoses and necrosis also supports the diagnosis of EAML [ 18 ].

With the rapid development of next-generation sequencing (NGS) and whole-exome sequencing (WES) technologies, researchers have made further progress in understanding the relationship between the disease and molecular biomarkers. Pathway inactivation due to P53 mutations is a key genetic step in many tumor types [ 18 ]. The clinical significance of Ki-67 as a proliferation marker and prognostic indicator has been extensively studied in human tumors [ 19 ]. Li found that EAML commonly exhibits higher expression levels of P53 and Ki-67 compared with CAML [ 20 ], which aligns with the results of this patient. Moreover, studies have shown EAML is related to high expression of MDM2 [ 21 ] and TFE3 [ 22 ]. This research provide new insights into potential molecular biomarkers for the diagnosis and differentiation of EAML.

EAML, as a relatively rare subtype of renal angiomyolipoma, has garnered increasing attention from researchers and clinical practitioners in recent years. However, due to its overlapping clinical features and radiological findings with renal cancer and CAML, EAML is prone to misdiagnosis preoperatively. Although there is currently no standard diagnostic guideline for EAML, with the popularization of diagnostic techniques, continuous accumulation of cases, and rapid development of molecular biology techniques, it is believed that future clinical diagnoses and treatments of EAML will advance to a higher level.

This case underscores the clinical impact of EAML and its potential for misdiagnosis. It draws attention to the need for heightened awareness among clinicians about this rare entity. It is necessary to make a comprehensive diagnosis based on clinical symptoms, imaging manifestations, and pathological characteristics to avoid unnecessary radical surgeries and optimize patient outcomes.

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Abbreviations

Renal epithelioid angiomyolipoma

Classic angiomyolipoma

Renal cell carcinoma

Computed tomography

Computed tomography angiography

Magnetic resonance imaging

Electron capture tomography

Tuberous sclerosis complex

Next-generation sequencing

Whole-exome sequencing

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Acknowledgements

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This work was supported by Zhejiang Medical Association Fund Project (award no. 2023ZYC-Z03) and Zhejiang Traditional Chinese Medicine Administration (award no. 2024ZL387).

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Wenhao Zhang, Xiaodong Jin, Shaobo Jiang, Jiasheng Yan & Yubing Li

Department of Pathology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310006, Zhejiang, People’s Republic of China

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Wenhao Zhang: writing—original draft, conceptualization. Xiaodong Jin: visualization. Chundan Wang: formal analysis. Shaobo Jiang: writing—review and editing. Jiasheng Yan: investigation. Yubing Li: conceptualization, supervision.

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Zhang, W., Jin, X., Wang, C. et al. Spontaneous rupture and hemorrhage of renal epithelioid angiomyolipoma misdiagnosed to renal carcinoma: a case report. J Med Case Reports 18 , 425 (2024). https://doi.org/10.1186/s13256-024-04743-5

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DOI : https://doi.org/10.1186/s13256-024-04743-5

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Assessing pediatric antibiotic knowledge and practices among community pharmacists in Palestine: implications for antibiotic use and resistance

• Banan M. Aiesh 1 , 2 ,
• Salsabeel Saleh 2 ,
• Nadine Matouk 2 ,
• Marah Labadi 2 ,
• Sanaa Kmail 2 ,
• Zaina Baddad 2 ,
• Amer A. Koni 2 , 3 ,
• Samah W. Al-Jabi 2 &
• Sa’ed H. Zyoud 2 , 4 , 5  

BMC Pediatrics volume  24 , Article number:  582 ( 2024 ) Cite this article

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Antibiotics are widely used in the pediatric population, and their inappropriate use contributes to antibiotic resistance, which is a growing concern in developing countries. Therefore, this national cross-sectional study aimed to assess community pharmacists’ knowledge, attitudes and practices regarding appropriate antibiotic use and dosing in pediatric patients and to explore the barriers to such use in Palestine.

A questionnaire-based survey was conducted among community pharmacists on the West Bank, Palestine, from September 2022 to March 2023. The survey assessed the pharmacists’ sociodemographic characteristics; knowledge, practices, and attitudes toward antibiotic use; and understanding of antibiotic dosing. The data were analyzed using descriptive statistics, and the factors affecting pharmacists’ knowledge were evaluated.

The study included 301 community pharmacists, with an average age of 30.06 years, who were primarily female (75.1%). The majority of the pharmacists (80.1%) correctly believed that antibiotics are effective against bacterial infections. However, 18.3% believed that antibiotics are effective against viruses. While 61.8% knew that antibiotics kill germs, 32.0% were unaware that not all antibiotics require refrigeration. Furthermore, 67.8% were aware that antibiotics do not speed up recovery from diarrhea. Over 99% of the participants recognized that antibiotic resistance developed due to various resistant mechanisms. The majority (78.7%) believed that each infection needed a different antibiotic. Pharmacists demonstrated reasonable knowledge of antibiotic dosing in case scenarios. Knowledge was positively correlated with years of experience ( P  = 0.001).

Conclusions

This study revealed that community pharmacy professionals have a good understanding of antibiotic usage in pediatric patients. The findings suggest that professional expertise and quality training improve healthcare services. However, the results may not be universally applicable, as identifying knowledge gaps is necessary to help with the development of focused interventions. Therefore, ongoing educational initiatives, awareness campaigns and antibiotic stewardship programs are recommended.

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Antibiotics are substances that specifically target bacteria, as they can inhibit growth and even kill bacteria; hence, they are intended to treat and prevent bacterial infections [ 1 , 2 , 3 ]. Antibiotics are among the most commonly prescribed medications, especially for childhood illnesses, as in pediatric dentistry [ 4 , 5 ]. However, the major contributors to outpatient visits are acute diarrhea, acute upper or lower respiratory infection, and viral infection with fever, indicating that only a small percentage of pediatric patients (< 20%) need antibiotic therapy [ 6 ]. On the other hand, the most common condition in pediatric patients who require antibiotic prescription is acute otitis media, as reported in the United States and Canada [ 7 , 8 ]. While antibiotics are critical in healthcare, their usage in pediatric care, especially in developing countries, presents unique challenges. According to previous studies, antibiotics are responsible for 27% of medication-related pediatric medical errors and 19% of hazardous errors caused by systemic antibiotic use [ 9 , 10 , 11 ], especially those related to antibiotic dosing [ 5 ]. Antibiotic dosage is determined by taking into account a number of factors, including age, weight, and coexisting disorders [ 12 , 13 ]. Furthermore, the lack of clinical trials on antibiotics for pediatric patients and the lack of new antibiotic pipelines have led to a paucity of high-level evidence [ 14 , 15 ]. Antibiotic resistance has reached an alarming level worldwide, particularly in developing countries [ 16 , 17 ]. The inappropriate use of antibiotics, particularly broad-spectrum antibiotics for these childhood diseases, has contributed largely to the evolution of antibiotic resistance [ 6 ], and this is the most serious problem worldwide [ 18 ]. Cultural, educational, behavioral, and socioeconomic factors are among the numerous factors that contribute to antibiotic resistance. Therefore, the exacerbation of antibiotic resistance must be clearly and deeply known by all members of the health care system, including pharmacists, and a plan must be presented for an effective strategy to improve antibiotic use and the creation of antibiotic supervision programs to prevent further spread of antibiotic resistance.

While many studies on the appropriate use and dosage of antibiotics for children have been undertaken in various regions of the world, relatively few studies have focused on Palestinian community pharmacists to assess this topic [ 5 , 19 , 20 , 21 , 22 , 23 , 24 ]. This national study aimed to evaluate the knowledge of community pharmacists on the northern West Bank of Palestine on the appropriate use and dosing of antibiotics for pediatric patients. Overall, this study highlights the importance of increasing awareness campaigns to promote appropriate antibiotic use in pediatric patients. The results of this study may be valuable for policymakers and healthcare providers in developing local guidelines and interventions to improve appropriate antibiotic use.

Study design and setting

This was a cross-sectional questionnaire-based study that was conducted in Palestine from September 11, 2022, to March 27, 2023, targeting pharmacists working in community pharmacies. Participants were approached from 5 different cities, Nablus, Jenin, Tubas, Tulkarm, and Qalqilya, and from their respective villages and camps, which represent northern Palestine. The data were gathered through the use of a well-organized questionnaire distributed online. This online survey was administered via the SurveyMonkey platform and subsequently disseminated across various digital channels, including WhatsApp, Facebook Messenger, Facebook, and email. Due to logistical limitations, we opted for online data collection methods instead of in-person visits to specific districts. Notably, many other studies have also supported the use of a self-administered questionnaire survey method for data collection [ 6 , 25 , 26 ]. Approximately 10–15 min were needed to complete the questionnaire. The study protocol was approved by the Institutional Review Board (IRB) of An-Najah National University.

Sampling procedure

According to a previous study [ 27 ], there were 2350 pharmacists in Nablus, Jenin, Tubas, and Qalqilya. The Daniel formula was used [ 28 ]; n = Z2*P (1-P)/d2, where n = the calculated sample size for populations exceeding 10,000, z = 1.96 (95% CI), d = 0.05 (absolute precision as a margin of error), and P  = 0.5 expected prevalence or response distribution. The sample size was 385 participants. However, since our population was less than 10,000 ( N  = 2,350), we adjusted this number using the adjusted sample equation; adjusted sample = n/(1 + (n/N)). The sample size needed was approximately 331, considering a 5% margin of error, a response of 50%, and a 95% confidence interval.

Questionnaire development

A thorough evaluation of relevant surveys was performed to identify potentially relevant questions for the questionnaire utilized in our study [ 5 , 21 , 26 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. A comprehensive review of the questionnaire was performed to validate the questions and ensure that the answers were correct. The questionnaire was subsequently sent to specialists with extensive research experience, including an infectious disease medical doctor, an infectious disease clinical pharmacist, and an academic pharmacy researcher. These experts conducted individual reviews of the questionnaire and made comments and modifications. The initial version of the questionnaire was adjusted based on their recommendations. Minor modifications were also made in the subsequent revisions until the final version was obtained. The infectious disease specialists provided correct answers. Finally, all specialists read the final edit and approved it.

Prior to the release of the survey, a pilot study of ten questionnaires was performed to analyze and clarify the questionnaire items. The questionnaire has four major components:

The first part contains questions regarding sociodemographic characteristics (gender, age, years of working, etc.).

The second part included questions assessing participants’ knowledge, practices, and attitudes toward antibiotic use and antimicrobial resistance.

The third part was composed of questions regarding a case scenario for antibiotic dosing and labeling of instructions.

The fourth part concentrates on evaluating the barriers and obstacles to the appropriate prescription and use of antibiotics, as well as the effects of sociodemographic factors on the knowledge of community pharmacists about appropriate antibiotic use in pediatrics.

Inclusion and exclusion criteria

The study included pharmacists in the northern West Bank (Jenin, Nablus, Tulkarm, Qalqilya, Tubas, and their villages and camps), provided that they were registered with Palestine Pharmacists Syndicate and working community pharmacies aged 23 years and older. The study excluded nonworking pharmacists and pharmacists working in pharmaceutical fields other than community pharmacies, such as hospital pharmacies, pharmaceutical factories, and medical representatives.

Statistical analysis

Data analysis was performed with IBM SPSS version 29. Descriptive analysis was used to summarize the data, including frequency and percentage for categorical variables and mean and median for continuous variables. The total knowledge score for antibiotics was calculated and ranged from zero to fifteen, where a score of zero indicated that all questions were answered incorrectly and a score of fifteen indicated that all questions were answered correctly. The pharmacists were then classified as knowledgeable or non-knowledgeable based on their total score. Non-knowledgeable pharmacists were those who answered fewer than eight questions correctly, while knowledgeable pharmacists were those who scored eight or more points. The Mann‒Whitney test was used for binary variables, the Kruskal‒Wallis test was used for variables with more than two groups to analyze the knowledge score, and a p value less than 0.05 was considered to indicate statistical significance.

Sociodemographic characteristics of the study sample

Among the 301 community pharmacists who completed the questionnaire, the average age was 30.06 years, and the vast majority of the pharmacists were females (75.1%). Approximately half of them lived in the city (49.8%). In addition, 87.7% of them graduated from Palestinian universities, and more than half worked as pharmacy employees (67.4%). In addition, most of the participants had less than 5 years of experience (60.8%). All the details can be found in Table  1 .

Knowledge of community pharmacists in Palestine on antibiotics

The pharmacists’ knowledge about antibiotics is shown in Table  2 . The results showed that 18.3% of the pharmacists still believed that antibiotics were effective against viruses. More than half of the pharmacists thought that antibiotics were effective for coughs lasting more than a week, and 61.8% answered that antibiotics were useful for killing germs. Only 67.8% knew that diarrhea did not improve faster with antibiotics.

Antibiotic resistance, according to more than 99% of the pharmacists in our study, occurs when bacteria develop various resistance mechanisms against the effects of antibiotics, and 92.1% of the pharmacists agreed that it can be very difficult to treat the infections they cause.

When azithromycin was used for acute bacterial pharyngitis, 93% of the pharmacists correctly answered that trimethoprim/sulfamethoxazole can be used for lower urinary tract infections. For the otitis and sinusitis scenarios, our findings showed that the majority of pharmacists (92.7% and 81.1%, respectively) correctly answered the use of amoxicillin/clavulanate and cefdinir as therapeutic options.

Practices of community pharmacists in Palestine toward pediatric antibiotics

A descriptive analysis of the practices of community pharmacists toward pediatric antibiotics is shown in Table  3 . For example, adaptation to pediatric antibiotic prescriptions was rated as very good for 32.6% of pharmacists and weak for 3.7%. Regarding the recalculation of the dose written by the physician in the prescription of antibiotics for children, 30.6% were excellent, and 4.3% were weak. Furthermore, 34.9% of the patients were excellent, and 5.3% of them were weak in contacting the doctor when an inappropriate regimen (antibiotic dose/frequency is too high or too low) was noted. According to the analysis of the prescription scenario, 78% of the pharmacists gave instructions correctly, and 83% refused to fill prescriptions due to the wrong dosage (Table  4 ).

Attitudes of pharmacists toward antibiotic use

As noted in Tables  5 and 95.7% of the pharmacists considered themselves responsible for informing and educating parents who requested antibiotics for their children without a prescription and who were probably not in need of antibiotic therapy. Furthermore, 97% of them agreed that the medicine-related counseling of community pharmacists was just as important as the recommendations of the physician. However, there is some variation, where 20.3% of pharmacists dispense antibiotics without prescriptions due to the demands of parents. Furthermore, 80.4% of the pharmacists believed that nonprescription dispensing of antibiotics was a public health risk, and 47.5% of them offered probiotics for patients purchasing prescribed antibiotics.

Barriers that prevent the appropriate prescription and use of antibiotics

According to the pharmacists, there were many barriers that could prevent appropriate antibiotic prescription and use, such as parents’ behavior with respect to antibiotic use (91.7%), physician malpractice with respect to prescribing antibiotics (88.7%), and parents’ pressure to prescribe antibiotics (87.3%), as illustrated in Table  6 .

The effects of sociodemographic factors on the knowledge of community pharmacists about appropriate antibiotic use in pediatrics

The analysis of sociodemographic factors affecting the knowledge of community pharmacists about antibiotics showed that age, position in the pharmacy, social status, and years of work were independently associated with the knowledge of community pharmacists about antibiotics. Age was positively associated with pharmacist knowledge, as pharmacists aged 45 years and older were more knowledgeable than those under 45 years (P value = 0.013). Additionally, position in the pharmacy had a positive association with pharmacists’ knowledge, and pharmacists who were employees were more knowledgeable than those who were employers (P value = 0.002). Furthermore, years of work experience were positively associated with pharmacist knowledge: pharmacists with 5 years of working experience were more knowledgeable than those with less than 5 years of working experience (P value = 0.001). The details are shown in Table  7 .

The current study revealed that community pharmacists were highly knowledgeable about the appropriate prescription and use of antibiotics (98%). While pharmacists may not serve as prescribers in many countries, knowledge about the appropriate selection of antibiotics is crucial. They play an important role in conducting interventions or providing recommendations to clinicians regarding the appropriate choice of drugs. Several studies have evaluated pharmacists’ beliefs that antibiotics are not effective at treating cold, flu, or cough. In Jordan, 56.1% of pharmacists believed that antibiotics would never treat cold, cough, or flu [ 38 ]; Zakaa El-din et al. reported that 10.4% of the respondents thought that antibiotics are helpful for sore throat and common colds [ 39 ], while in Catalonia, Spain, 34.8% of pharmacists dispensed antibiotics for sore throat complaints [ 40 ]. In our study, 80.1% of the pharmacists were against prescribing antibiotics for these indications. However, 61.8% of the pharmacists responded that antibiotics are effective at killing germs. This could be attributed to the fact that the term “germs” is generally used with antibiotics rather than specific bacteria [ 37 ]. This demonstrates the critical need for pharmacists to be more knowledgeable about antibiotic indications, and they should feel obligated to make patients aware of their misuse and the consequences of their actions.

Almost all the pharmacists (99%) in our study responded that the misuse of antibiotics led to antimicrobial resistance, whereas 79% of those in the Jordanian study [ 38 ] and another Palestinian study (92.1%) reported antimicrobial resistance [ 41 ]. The substantial increase in knowledge could be attributed to the fact that community pharmacists are well educated and have professional skills and training that allow them to provide the best health care services [ 34 ], as well as the fact that many patients seek medical advice directly from community pharmacies because they are faster and less expensive than doctor clinic visits are and because they are considered reliable and easy to contact healthcare providers [ 39 , 42 ].

The level of practice in the current study was assessed by presenting one case scenario and six questions on the practices of community pharmacists in Palestine regarding pediatric antibiotics. Approximately 61.5% of community pharmacists correctly calculated the dose of amoxicillin, compared to 54% in Chicago [ 25 ]. The variability could be attributed to differences in study objectives and study populations (age groups, sample size), in addition to the fact that more than 99.9% of community pharmacies dispense amoxicillin and cephalexin over the counter, so they are familiar with the dosing [ 43 ].

Regarding the evaluation of the practices of community pharmacists in Palestine regarding pediatric antibiotics, 86.4% would consult physicians if they were uncertain about the appropriateness of antibiotic prescription. This finding is in agreement with the results of a study in Senegal (90.2%) [ 44 ] and greater than what was reported in the Jordanian study (53.5%) [ 38 ] as well as the study by Rehman et al. in Pakistan (32%) [ 45 ]. In Palestine, as in some developing countries, patients can obtain antibiotics from pharmacies without a prescription [ 27 , 39 ]. In fact, because some participants do not refer to physicians due to poor physician response, this may reflect the necessity of strengthening interprofessional relationships between healthcare teams, most likely starting with university curricula. Pharmacists and other health care practitioners should collaborate in multidisciplinary teams to minimize antimicrobial irrationality and inappropriate use and hence antimicrobial resistance. Understanding how to develop relationships with caregivers can help change their attitudes and increase the acceptability of pharmacists who interfere with children’s antibiotic prescriptions. Caregivers seeking symptom relief may be more amenable to nonantibiotic options [ 46 ]. With respect to dosing considerations, 85% of the pharmacists recalculated the dose written by the physician before dispensing the antibiotic. Almost 93% of the pharmacists correctly answered the question on utilizing azithromycin for acute bacterial pharyngitis. Similarly, the use of a trimethoprim/sulfamethoxazole dosage for treating lower urinary tract infections was identified for 93% of the patients. Our knowledge rates were higher than those reported by Keewan et al. in their study in Jordan [ 5 ], where the largest number of community pharmacists (55.8%) properly answered the case of azithromycin dose in acute bacterial pharyngitis, while 15.7% of the pharmacists correctly answered the dosing of trimethoprim-sulfamethoxazole in lower urinary tract infection. To ensure the accurate dispensing of antibiotics for pediatric patients, double-checking could be implemented.

Approximately 98% of participants agreed that education about antibiotic use and antibiotic resistance should be more prominent during university education years, as concluded by studies in India [ 47 ], Trinidad and Tobago [ 48 ], and East Africa [ 49 ].

In our study, several factors exhibited statistically significant associations with pharmacist knowledge. These factors include younger age, employment status within a community pharmacy, and an accumulation of more than five years of professional experience. A study carried out in the West Bank, Palestine, demonstrated that women and those living in urban areas have higher knowledge scores [ 41 ]. On the other hand, it was discovered that pharmacist education, professional title, and years of experience had an impact on the pharmacist’s understanding of antimicrobial medications [ 50 ]. These findings highlight the importance of customizing antimicrobial stewardship programs to meet pharmacist requirements, taking into account sociodemographic differences. In addition, regarding the years spent working in the pharmacy, this association could be because pharmacists spend much time in the pharmacy, which means more time communicating with patients, prescriptions, and promotional representatives who scientifically explain their medications.

Several community pharmacists have reported barriers that can contribute to inappropriate antibiotic use in pediatrics. Among them, parental behavior and pressure to prescribe antibiotics (91.7% and 87.3%, respectively) were the barriers most frequently reported. This was followed by malpractice in antibiotic prescribing (88.7%). These findings were consistent with a study conducted in Lebanon in which pharmacists first blamed parents (90.1%), second-level physicians (72.8%) and third-level physicians (59.4%) for inappropriate antibiotic use and the emergence of antimicrobial resistance [ 37 ]. Furthermore, in Qatar, patients and practitioners, mainly physicians, play a role in shaping barriers to appropriate antibiotics [ 26 ]. In contrast, unfounded assumptions about the efficacy of antibiotics by health professionals, as well as an exaggeration of parents’ desire for medications, may be the key contributing cause of antibiotic overprescription for the common cold in Korea [ 51 ]. This would support the need for antibiotic stewardship programs and effective behavior change programs that are getting off to a good start to optimize antibiotic prescription.

Strengths and limitations

The strengths of this study include the high number of responses and the scenario design that community pharmacists are more likely to encounter; moreover, the study succeeded in containing clear questions about practices and attitudes toward antibiotic use. This is the first study in the West Bank, Palestine, to discuss antibiotic use and dosing among pediatric patients. However, there are a few limitations. For example, using the cross-sectional design in this study prevented us from interpreting the causality of significant associations. In addition, the current study is based on the real practice of pharmacists with respect to antibiotic use, so the pharmacist might check a reference or consult a colleague when answering the cases, which could lead to an overestimation of pharmacist knowledge. Additionally, the research in question employed an online survey featuring a convenience sample. Consequently, there is potential for bias, as the survey’s reach may be confined to individuals with internet connectivity. Furthermore, the utilization of the convenience-oriented snowball sampling method raises concerns about the representativeness of this study’s findings in relation to the entirety of Palestinian pharmacies. The smaller sample size and the use of online surveys may limit the generalizability of the study’s findings to the entire population of pharmacists in the northern West Bank of Palestine. However, the final sample size remains statistically robust for analysis considering the population size. Further research with a larger sample size and a more representative recruitment strategy could strengthen the generalizability of the results. The final constraint pertains to the study’s design, which adopts a cross-sectional analysis. This design impedes the identification of causation and limits the generalizability of the study’s findings.

This study aimed to assess the level of knowledge possessed by community pharmacy professionals with regard to the correct use of antibiotics by pediatric patients. The investigation revealed that a significant proportion of community pharmacists demonstrated a commendable understanding of the appropriate usage of antibiotics. Furthermore, the outcomes indicated a positive correlation between pharmacists’ knowledge and their years of professional experience and social status. This observation lends support to the proposition that the acquisition of professional expertise and the quality of training contribute to the provision of enhanced healthcare services. The findings derived from this investigation provide valuable insights into the proper use of antibiotics in pediatric care. Nevertheless, it is worth noting that the results of this study may not be readily generalizable to a broader population. Consequently, it is advisable to implement ongoing educational programs, including interactive workshops and lectures led by infectious disease specialists, under the coordination and support of the Palestinian Pharmacist Syndicate and awareness campaigns aimed at enhancing the prescription and utilization of antibiotics among community pharmacists. This recommendation is especially pertinent in light of the continuously evolving guidelines and evolving information within this domain.

Future perspectives

This study emphasizes the need for continuous educational and awareness efforts to improve the understanding of proper antibiotic use and prescription guidelines among children. Due to the high frequency of mistakes in pharmaceuticals, especially related to dosage, providing effective treatments for children is crucial for reducing this problem and improving patient safety standards. Future research efforts may focus on developing and implementing educational programs specifically designed to enhance the knowledge and skills of community pharmacists in this field. Moreover, there is a significant advantage in educating parents and caregivers on the prudent use of antibiotics and the possible risks associated with prescription inconsistencies. This can be achieved through the use of educational materials, such as brochures distributed in pediatric clinics. In addition, community pharmacists should take the lead in ensuring that parents understand the instructions, risks, and proper use of antibiotics. Furthermore, future research may aim to examine the impact of these treatments on the prescription practices of pharmacists, patient health outcomes, and healthcare costs. In conclusion, the results of this study have the potential to impact policy choices and inspire practical improvements in the quality of care for children while limiting the risk of prescription mistakes.

Data availability

The data sets supporting the results of the present research are available from the corresponding authors upon request.

Abbreviations

Institutional Review Board

New Israeli Shekel

Doctorate of Philosophy

Statistical Package for the Social Sciences

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Acknowledgements

Many thanks to the Clinical Research Centre of An-Najah National University Hospital for constant support and wise advice.

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Department of Infection Prevention and Control, An-Najah National University Hospital, Nablus, 44839, Palestine

Banan M. Aiesh

Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine

Banan M. Aiesh, Salsabeel Saleh, Nadine Matouk, Marah Labadi, Sanaa Kmail, Zaina Baddad, Amer A. Koni, Samah W. Al-Jabi & Sa’ed H. Zyoud

Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine

Amer A. Koni

Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine

Sa’ed H. Zyoud

Clinical Research Center, An-Najah National University Hospital, Nablus, 44839, Palestine

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Contributions

SS, NM, ML, SK, and ZB performed data collection, reviewed the literature and data analysis and wrote the draft manuscript. SA and AK participated in data analysis and wrote the draft manuscript. SZ and BA conceptualized and designed the study, coordinated, supervised, and analyzed the data, critically reviewed the manuscript to improve intellectual content, and assisted in the final manuscript review. Then, all the authors reviewed and accepted the final manuscript.

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Correspondence to Sa’ed H. Zyoud .

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Ethics approval and consent to participate.

The present study received approval from the Institutional Review Board (IRB) of An-Najah National University (Ref: Pharm D. Sep. 2022/34). In accordance with the principles of informed consent, the act of survey completion was construed as a manifestation of participants’ consent, given that the survey was distributed via online platforms utilizing a SurveyMonkey ® account. Information concerning voluntary participation and the right to withdraw from the study was provided within the invitation, prominently displayed on the cover page. The cover page additionally elucidated the study’s objectives and provided guidance on how to respond to the survey questions. The data collected during the course of this study were exclusively utilized for research purposes and were diligently safeguarded to ensure anonymity and confidentiality. Participants were not provided with any form of incentive to motivate their survey participation. The IRB of An-Najah National University deemed it appropriate to waive the necessity for written informed consent, as the study was considered to pose minimal risk, and all procedures adhered rigorously to pertinent guidelines and regulations.

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Aiesh, B.M., Saleh, S., Matouk, N. et al. Assessing pediatric antibiotic knowledge and practices among community pharmacists in Palestine: implications for antibiotic use and resistance. BMC Pediatr 24 , 582 (2024). https://doi.org/10.1186/s12887-024-05060-y

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Received : 21 October 2023

Accepted : 05 September 2024

Published : 14 September 2024

DOI : https://doi.org/10.1186/s12887-024-05060-y

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