case study of review

Organizing Your Social Sciences Research Paper: Writing a Case Study

• Purpose of Guide
• Design Flaws to Avoid
• Independent and Dependent Variables
• Glossary of Research Terms
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Choosing a Title
• Making an Outline
• Paragraph Development
• Executive Summary
• The C.A.R.S. Model
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Reading Research Effectively
• Primary Sources
• Secondary Sources
• Tiertiary Sources
• What Is Scholarly vs. Popular?
• Qualitative Methods
• Quantitative Methods
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Writing Concisely
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Annotated Bibliography
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• Types of Structured Group Activities
• Group Project Survival Skills
• Multiple Book Review Essay
• Reviewing Collected Essays
• Writing a Case Study
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Research Proposal
• Bibliography

The term case study refers to both a method of analysis and a specific research design for examining a problem, both of which are used in most circumstances to generalize across populations. This tab focuses on the latter--how to design and organize a research paper in the social sciences that analyzes a specific case.

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

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

How to Approach Writing a Case Study Research Paper

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

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

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

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

Structure and Writing Style

The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work. In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I.  Introduction

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

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

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

II.  Literature Review

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

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

III.  Method

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

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

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experience he or she has had that provides an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of his/her experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using him or her as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem.

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

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

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

IV.  Discussion

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

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

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

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

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

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

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

V.  Conclusion

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

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

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

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

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

Problems to Avoid

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

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

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

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

Writing Tip

At Least Five Misconceptions about Case Study Research

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

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

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

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

• << Previous: Reviewing Collected Essays
• Next: Writing a Field Report >>
• Last Updated: Jan 17, 2023 10:50 AM
• URL: https://libguides.pointloma.edu/ResearchPaper

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, generate accurate citations for free.

• Knowledge Base

Methodology

• 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.

Prevent plagiarism. Run a free check.

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.

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

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

McCombes, S. (2023, November 20). What Is a Case Study? | Definition, Examples & Methods. Scribbr. Retrieved September 4, 2024, from https://www.scribbr.com/methodology/case-study/

Is this article helpful?

Shona McCombes

Other students also liked, primary vs. secondary sources | difference & examples, what is a theoretical framework | guide to organizing, what is action research | definition & examples, get unlimited documents corrected.

✔ Free APA citation check included ✔ Unlimited document corrections ✔ Specialized in correcting academic texts

• Open access
• Published: 06 April 2016

How to review a case report

• Rakesh Garg 1 ,
• Shaheen E. Lakhan 2 &
• Ananda K. Dhanasekaran 3  

Journal of Medical Case Reports volume  10 , Article number:  88 ( 2016 ) Cite this article

72k Accesses

19 Citations

3 Altmetric

Metrics details

Peer Review reports

Introduction

Sharing individual patient experiences with clinical colleagues is an essential component of learning from each other. This sharing of information may be made global by reporting in a scientific journal. In medicine, patient management decisions are generally based on the evidence available for use of a particular investigation or technology [ 1 ]. The hierarchical rank of the evidence signifies the probability of bias. The higher up the hierarchy, the better its reliability and thus its clinical acceptance (Table  1 ). Though case reports remain lowest in the hierarchy of evidence, with meta-analysis representing the highest level, they nevertheless constitute important information with regard to rare events and may be considered as anecdotal evidence [ 2 ] (Table  1 ). Case reports may stimulate the generation of new hypotheses, and thus may support the emergence of new research.

The definition of a case report or a case series is not well defined in the literature and has been defined variously by different journals and authors. However, the basic definition of a case report is the detailed report of an individual including aspects like exposure, symptoms, signs, intervention, and outcome. It has been suggested that a report with more than four cases be called a case series and those with fewer than four a case report [ 3 ]. A case series is descriptive in design. Other authors describe “a collection of patients” as a case series and “a few patients” as a case report [ 4 ]. We suggest that should more than one case be reported, it may be defined as a case series—a concept proposed by other authors [ 5 ].

The importance of case reports

A case report may describe an unusual etiology, an unusual or unknown disorder, a challenging differential diagnosis, an unusual setting for care, information that can not be reproduced due to ethical reasons, unusual or puzzling clinical features, improved or unique technical procedures, unusual interactions, rare or novel adverse reactions to care, or new insight into the pathogenesis of disease [ 6 , 7 ]. In recent years, the publication of case reports has been given low priority by many high impact factor journals. However, the need for reporting such events remains. There are some journals dedicated purely to case reports, such as the Journal of Medical Case Reports , emphasizing their importance in modern literature. In the past, isolated case reports have led to significant advancements in patient care. For example, case reports concerning pulmonary hypertension and anorexic agents led to further trials and the identification of the mechanism and risk factors associated with these agents [ 2 , 8 ].

Reporting and publishing requirements

The reporting of cases varies for different journals. The authors need to follow the instructions for the intended publication. Owing to significant variability, it would be difficult to have uniform publication guidelines for case reports. A checklist called the CARE guidelines is useful for authors writing case reports [ 9 , 10 ]. However, it would be universally prudent to include a title, keywords, abstract, introduction, patient information, clinical findings, timeline, diagnostic assessment, therapeutic interventions, follow-up and outcomes, discussion, patient perspective, and informed consent.

Peer review process

The peer review process is an essential part of ethical and scientific writing. Peer review ultimately helps improve articles by providing valuable feedback to the author and helps editors make a decision regarding publication. The peer reviewer should provide unbiased, constructive feedback regarding the manuscript. They may also highlight the strengths and weaknesses of the report. When reviewing an article, it is prudent to read the entire manuscript first to understand the overall content and message. The reviewer than may read section-wise and provide comments to the authors and editorial team accordingly. The reviewer needs to consider the following important points when reviewing a case for possible publication [ 8 , 9 ] (summarized in Table  2 ).

Novelty remains the foremost important aspect of a case. The case report should introduce novel aspects of patient evaluation, investigation, treatment, or any other aspect related to patient care. The relevant information becomes a hypothesis generator for further study. The novelty may at times be balanced with some important information like severe adverse effects, even if they have been reported earlier. Reporting adverse events remains important so that information on cumulative adverse effects can be gathered globally, which helps in preparing a policy or guideline or a warning note for its use in patients. The data related to adverse effects include not only the impact but also the number of patients affected. This becomes more important for serious adverse effects. In the absence of an international registry for adverse effects, published case reports are important pieces of information. Owing to ethical concerns, formal evaluation may not be feasible in the format of prospective study.

Essential description

The case needs to have all essential details to allow a useful conclusion to emerge. For example, if a case is being reported for hemodynamic variability due to a drug, then the drug dose and timing along with timed vital signs need to be described.

Authenticity and genuineness

Honesty remains the most important basic principle of all publications. This remains a primary responsibility of the authors. However, if there is any doubt, reviewers may seek clarification. This doubt may result from some discordance in the case description. At times, a lack of correlation between the figures and description may act as “red flags.” For instance, authors may discuss a technique for dealing with a difficult airway, but the figure is of a normal-appearing airway. Another example would be where the data and figure do not correlate in a hemodynamic response related to a drug or a technique, with the graphical picture or screenshot of hemodynamics acting as an alert sign. Such cause for concern may be communicated in confidence to the editor.

Ethical or competing interests

Ethical issues need to be cautiously interpreted and communicated. The unethical use of a drug or device is not desirable and often unworthy of publication. This may relate to the route or dose of the drug administered. The off-label use of drugs where known side effects are greater than potential benefit needs to be discouraged and remains an example of unethical use. This use may be related to the drug dose, particularly when the drug dose exceeds the routine recommended dose, or to the route of administration. As an example, the maximal dose of acetaminophen (paracetamol) is 4g/day, and if an author reports exceeding this dose, it should be noted why a greater than recommended dose was used. Ultimately, the use of a drug or its route of administration needs to be justified in the manuscript. The reviewers need to serve as content experts regarding the drugs and other technologies used in the case. A literature search by the reviewer provides the data to comment on this aspect.

Competing interests (or conflicts of interest) are concerns that interfere or potentially interfere with presentation, review, or publication. They must be declared by the authors. Conflicts can relate to patient-related professional attributes (like the use of a particular procedure, drug, or instrument) being affected by some secondary gains (financial, non-financial, professional, personal). Financial conflict may be related to ownership, paid consultancy, patents, grants, honoraria, and gifts. Non-financial conflicts may be related to memberships, relationships, appearance as an expert witness, or personal convictions. At times, the conflict may be related to the author’s relationship with an organization or another person. A conflict may influence the interpretation of the outcome in an inappropriate and unscientific manner. Although conflicts may not be totally abolished, they must be disclosed when they reasonably exist. This disclosure should include information such as funding sources, present membership, and patents pending. Reviewers should cautiously interpret any potential bias regarding the outcome of the case based on the reported conflicts. This is essential for transparent reporting of research. At times, competing interests may be discovered by a reviewer and should be included in comments to the editorial team. Such conflicts may again be ascertained when the reviewer reviews the literature during the peer review process. The reviewer should also disclose their own conflicts related to the manuscript review when sending their report to the editorial team.

Impact on clinical practice

This is an important aspect for the final decision of whether to publish a case report. The main thrust or carry-home message needs to be emphasized clearly. It needs to be elaborated upon in concluding remarks.

Patient anonymity, consent, and ethical approval

When reviewing the manuscript of a case report, reviewers should ensure that the patient’s anonymity and confidentiality is protected. The reviewers should check that patient identifiers have been removed or masked from all aspects of the manuscript, whether in writing or within photograph. Identifiers can include things like the name of the patient, geographical location, date of birth, phone numbers, email of the patient, medical record numbers, or biometric identifiers. Utmost care needs to be taken to provide full anonymity for the patient.

Consent is required to participate in research, receive a certain treatment, and publish identifiable details. These consents are for different purposes and need to be explained separately to the patient. A patient’s consent to participate in the research or for use of the drug may not extend to consent for publication. All these aspects of consent must be explained to the patient, written explicitly in the patient’s own language, understood by the patient, and signed by the patient. For the purpose of the case, the patient must understand and consent for any new technique or drug (its dose, route, and timing) being used. In the case of a drug being used for a non-standard indication or route, consent for use must also be described. Patient consent is essential for the publication of a case if patient body parts are displayed in the article. This also includes any identifiers that can reveal the identity of the patient, such as the patient’s hospital identification number, address, and any other unique identifier. In situations where revealing the patient’s identity cannot be fully avoided, for example if the report requires an image of an identifiable body part like the face, then this should be explained to the patient, the image shown to them, and consent taken. Should the patient die, then consent must be obtained from next of kin or legal representative.

With case series, securing individual patient consent is advised and preferable. The authors may also need institutional review board (IRB) approval to publish a case series. IRBs can waive the need for consent if a study is conducted retrospectively and data are collected from patient notes for the purpose of research, usually in an anonymized way. However, wherever possible, individual patient consent is preferable, even for a retrospective study. Consent is mandatory for any prospective data collection for the purpose of publication as a case series. Consent and/or IRB approval must be disclosed in the case report and reasons for not obtaining individual consent may be described, if applicable.

There may be situations in which publishing patient details without their consent is justified, but this is a decision that should be made by the journal editor, who may decide to discuss the case with the Committee on Publication Ethics. Reviewers need to emphasize the issue to the editor when submitting their comments.

Manuscript writing

The CARE guidelines provide a framework that supports transparency and accuracy in the publication of case reports and the reporting of information from patient encounters. The acronym CARE was created from CA (the first two letters in “case”) and RE (the first two letters in “reports”). The initial CARE tools are the CARE checklist and the Case Report Writing Templates. These tools support the writing of case reports and provide data that inform clinical practice guidelines and provide early signals of effectiveness, harms, and cost [ 10 ].

The presentation of the case and its interpretation should be comprehensive and related. The various components of the manuscript should have sufficient information for understanding the key message of the case. The reviewer needs to comment on the relevant components of the manuscript. The reviewer should ascertain that the title of the case manuscript is relevant and includes keywords related to the case. The title should be short, descriptive, and interesting. The abstract should be brief, without any abbreviations, and include keywords. It is preferable to use Medical Subject Headings (MeSH) keywords. Reviewers must ensure that the introduction emphasizes the context of the case and describes the relevance and its importance in a concise and comprehensive manner. The case description should be complete and should follow basic rules of medical communication. The details regarding patient history, physical examination, investigations, differential diagnosis, management, and outcome should be described in chronological order. If repeated observations are present, then they may be tabulated. The use of graphs and figures helps the readers to better understand the case. Interpretation or inferences based on the outcomes should be avoided in this section and should be considered a part of the discussion. The discussion should highlight important aspects of the case, with its interpretation within the context of the available literature. References should be formatted as per the journal style. They should be complete and preferably of recent publications.

Reviewer responsibility

The reviewer’s remarks are essential not only for the editorial team but also for authors. A good peer review requires honesty, sincerity, and punctuality. Even if a manuscript is rejected, the authors should receive learning points from peer review commentary. The best way to review a manuscript is to read the manuscript in full for a gross overview and develop general comments. Thereafter, the reviewer should address each section of the manuscript separately and precisely. This may be done after a literature search if the reviewer needs to substantiate his/her commentary.

Constructive criticism

The reviewer’s remarks should be constructive to help the authors improve the manuscript for further consideration. If the manuscript is rejected, the authors should have a clear indication for the rejection. The remarks may be grouped as major and minor comments. Major comments likely suggest changes to the whole presentation, changing the primary aim of the case report, or adding images. Minor comments may include grammatical errors or getting references for a statement. The editorial team must be able to justify their decision on whether or not to accept an article for publication, often by citing peer review feedback. It is also good style to tabulate a list of the strengths and weaknesses of the manuscript.

Fixed time for review

Reviewer remarks should be submitted within a specified timeframe. If any delay is expected, it should be communicated to the editorial team. Reviewers should not rush to submit feedback without sufficient time to adequately review the paper and perform any necessary literature searches. Should a reviewer be unable to submit the review within the specified timeframe, they should reply to the review invitation to decline at their earliest convenience. If, after accepting a review invitation, the reviewer realizes they do not have time to perform the review, this must be communicated to the editorial team.

Conflict of interest

The reviewer’s conflicts of interest should be included along with the review. The conflicts may be related to the contents of the case, drugs, or devices pertaining to the case; the author(s); or the affiliated institution(s) of the author(s).

Lack of expertise

The reviewer may decline to review the manuscript if they think the topic is out of their area of expertise. If, after accepting an invitation to review, the reviewer realizes they are unable to review the manuscript owing to a lack of expertise in that particular field, they should disclose the fact to the editorial team.

Confidentiality

The reviewer should keep the manuscript confidential and should not use the contents of the unpublished manuscript in any form. Discussing the manuscript among colleagues or any scientific forum or meetings is inappropriate.

Review of revised manuscript

At times, a manuscript is sent for re-review to the reviewer. The reviewer should read the revised manuscript, the author’s response to the previous round of peer review, and the editorial comments. Sometimes, the authors may disagree with the reviewer’s remarks. This issue needs to be elaborated on and communicated with the editor. The reviewer should support their views with appropriate literature references. If the authors justify their reason for disagreeing with the viewer, then their argument should be considered evidence-based. However, if the reviewer still requests the revision, this may be politely communicated to the author and editor with justification for the same. In response to reviewers remarks, authors may not agree fully and provide certain suggestion in the form of clarification related to reviewers remarks. The reviewers should take these clarifications judiciously and comment accordingly with the intent of improving the manuscript further.

Peer reviewers have a significant role in the dissemination of scientific literature. They act as gatekeepers for science before it is released to society. Their sincerity and dedication is paramount to the success of any journal. The reviewers should follow a scientific and justifiable methodology for reviewing a case report for possible publication. Their comments should be constructive for the overall improvement of the manuscript and aid the editorial team in making a decision on publication. We hope this article will help reviewers to perform their important role in the best way possible. We send our best wishes to the reviewer community and, for those who are inspired to become reviewers after reading this article, our warm welcome to the reviewers’ club.

Burns PB, Rohrich RJ, Chung KC. The levels of evidence and their role in evidence-based medicine. Plast Reconstr Surg. 2011;128:305–10.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Green BN, Johnson CD. How to write a case report for publication. J Chiropr Med. 2006;5:72–82.

Article   PubMed   PubMed Central   Google Scholar  

Abu-Zidan FM, Abbas AK, Hefny AF. Clinical “case series”: a concept analysis. Afr Health Sci. 2012;12:557–62.

CAS   PubMed   PubMed Central   Google Scholar  

Porta M, editor. A dictionary of epidemiology/edited for the International Epidemiological Association. 5th ed. UK: Oxford University Press; 2008. p. 33.

Medical Research Council of South Africa. Evidence-based medicine. 2016. http://www.mrc.ac.za/healthsystems/sai.htm . Accessed on 1 Nov 2015.

Cohen H. How to write a patient case report. Am J Health-Syst Pharm. 2006;63:1888–92.

Article   PubMed   Google Scholar  

Roberts LW, Coverdale J, Edenharder K, Louie A. How to review a manuscript: a “down-to-earth” approach. Acad Psychiatry. 2004;28:81–7.

Rutowski JL, Cairone JV. How to review scientific manuscripts and clinical case reports for Journal of Oral Implantology. J Oral Implantol. 2009;35:310–4.

Article   Google Scholar  

Jabs DA. Improving the reporting of clinical case series. Am J Ophthalmol. 2005;139:900–5.

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D; CARE Group. The CARE guidelines: consensus-based clinical case reporting guideline development. BMJ Case Reports. 2013; doi: 10.1136/bcr-2013-201554 .

Download references

Author information

Authors and affiliations.

Department of Anaesthesiology, Pain and Palliative Care, DR BRAIRCH, AIIMS, Ansari Nagar, New Delhi, 110029, India

Rakesh Garg

Neurology and Medical Education, California University of Science and Medicine - School of Medicine, Colton, CA, USA

Shaheen E. Lakhan

Sandwell & West Birmingham Hospitals, NHS Trust, Birmingham, UK

Ananda K. Dhanasekaran

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Rakesh Garg .

Additional information

Competing interests.

The authors declare that they have no competing interests.

Authors’ contributions

All authors read and approved the final manuscript.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.

Reprints and permissions

About this article

Cite this article.

Garg, R., Lakhan, S.E. & Dhanasekaran, A.K. How to review a case report. J Med Case Reports 10 , 88 (2016). https://doi.org/10.1186/s13256-016-0853-3

Download citation

Received : 27 August 2015

Accepted : 25 February 2016

Published : 06 April 2016

DOI : https://doi.org/10.1186/s13256-016-0853-3

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Journal of Medical Case Reports

ISSN: 1752-1947

• Submission enquiries: Access here and click Contact Us
• General enquiries: [email protected]

• SUGGESTED TOPICS
• The Magazine
• Newsletters
• Managing Yourself
• Managing Teams
• Work-life Balance
• The Big Idea
• Data & Visuals
• Reading Lists
• Case Selections
• HBR Learning
• Topic Feeds
• Account Settings
• Email Preferences

What the Case Study Method Really Teaches

• Nitin Nohria

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

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

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

• Nitin Nohria is the George F. Baker Jr. and Distinguished Service University Professor. He served as the 10th dean of Harvard Business School, from 2010 to 2020.

Partner Center

• All Categories
• Marketing Analytics Software

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

In this post

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.

Want to learn more about Marketing Analytics Software? Explore Marketing Analytics products.

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.

Now is the time to get SaaS-y news and entertainment with our 5-minute newsletter,   G2 Tea , featuring inspiring leaders, hot takes, and bold predictions. Subscribe below!

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)

Explore More G2 Articles

• Open access
• Published: 27 June 2011

The case study approach

• Sarah Crowe 1 ,
• Kathrin Cresswell 2 ,
• Ann Robertson 2 ,
• Guro Huby 3 ,
• Anthony Avery 1 &
• Aziz Sheikh 2  

BMC Medical Research Methodology volume  11 , Article number:  100 ( 2011 ) Cite this article

792k Accesses

1111 Citations

42 Altmetric

Metrics details

The case study approach allows in-depth, multi-faceted explorations of complex issues in their real-life settings. The value of the case study approach is well recognised in the fields of business, law and policy, but somewhat less so in health services research. Based on our experiences of conducting several health-related case studies, we reflect on the different types of case study design, the specific research questions this approach can help answer, the data sources that tend to be used, and the particular advantages and disadvantages of employing this methodological approach. The paper concludes with key pointers to aid those designing and appraising proposals for conducting case study research, and a checklist to help readers assess the quality of case study reports.

Peer Review reports

Introduction

The case study approach is particularly useful to employ when there is a need to obtain an in-depth appreciation of an issue, event or phenomenon of interest, in its natural real-life context. Our aim in writing this piece is to provide insights into when to consider employing this approach and an overview of key methodological considerations in relation to the design, planning, analysis, interpretation and reporting of case studies.

The illustrative 'grand round', 'case report' and 'case series' have a long tradition in clinical practice and research. Presenting detailed critiques, typically of one or more patients, aims to provide insights into aspects of the clinical case and, in doing so, illustrate broader lessons that may be learnt. In research, the conceptually-related case study approach can be used, for example, to describe in detail a patient's episode of care, explore professional attitudes to and experiences of a new policy initiative or service development or more generally to 'investigate contemporary phenomena within its real-life context' [ 1 ]. Based on our experiences of conducting a range of case studies, we reflect on when to consider using this approach, discuss the key steps involved and illustrate, with examples, some of the practical challenges of attaining an in-depth understanding of a 'case' as an integrated whole. In keeping with previously published work, we acknowledge the importance of theory to underpin the design, selection, conduct and interpretation of case studies[ 2 ]. In so doing, we make passing reference to the different epistemological approaches used in case study research by key theoreticians and methodologists in this field of enquiry.

This paper is structured around the following main questions: What is a case study? What are case studies used for? How are case studies conducted? What are the potential pitfalls and how can these be avoided? We draw in particular on four of our own recently published examples of case studies (see Tables 1 , 2 , 3 and 4 ) and those of others to illustrate our discussion[ 3 – 7 ].

What is a case study?

A case study is a research approach that is used to generate an in-depth, multi-faceted understanding of a complex issue in its real-life context. It is an established research design that is used extensively in a wide variety of disciplines, particularly in the social sciences. A case study can be defined in a variety of ways (Table 5 ), the central tenet being the need to explore an event or phenomenon in depth and in its natural context. It is for this reason sometimes referred to as a "naturalistic" design; this is in contrast to an "experimental" design (such as a randomised controlled trial) in which the investigator seeks to exert control over and manipulate the variable(s) of interest.

Stake's work has been particularly influential in defining the case study approach to scientific enquiry. He has helpfully characterised three main types of case study: intrinsic , instrumental and collective [ 8 ]. An intrinsic case study is typically undertaken to learn about a unique phenomenon. The researcher should define the uniqueness of the phenomenon, which distinguishes it from all others. In contrast, the instrumental case study uses a particular case (some of which may be better than others) to gain a broader appreciation of an issue or phenomenon. The collective case study involves studying multiple cases simultaneously or sequentially in an attempt to generate a still broader appreciation of a particular issue.

These are however not necessarily mutually exclusive categories. In the first of our examples (Table 1 ), we undertook an intrinsic case study to investigate the issue of recruitment of minority ethnic people into the specific context of asthma research studies, but it developed into a instrumental case study through seeking to understand the issue of recruitment of these marginalised populations more generally, generating a number of the findings that are potentially transferable to other disease contexts[ 3 ]. In contrast, the other three examples (see Tables 2 , 3 and 4 ) employed collective case study designs to study the introduction of workforce reconfiguration in primary care, the implementation of electronic health records into hospitals, and to understand the ways in which healthcare students learn about patient safety considerations[ 4 – 6 ]. Although our study focusing on the introduction of General Practitioners with Specialist Interests (Table 2 ) was explicitly collective in design (four contrasting primary care organisations were studied), is was also instrumental in that this particular professional group was studied as an exemplar of the more general phenomenon of workforce redesign[ 4 ].

What are case studies used for?

According to Yin, case studies can be used to explain, describe or explore events or phenomena in the everyday contexts in which they occur[ 1 ]. These can, for example, help to understand and explain causal links and pathways resulting from a new policy initiative or service development (see Tables 2 and 3 , for example)[ 1 ]. In contrast to experimental designs, which seek to test a specific hypothesis through deliberately manipulating the environment (like, for example, in a randomised controlled trial giving a new drug to randomly selected individuals and then comparing outcomes with controls),[ 9 ] the case study approach lends itself well to capturing information on more explanatory ' how ', 'what' and ' why ' questions, such as ' how is the intervention being implemented and received on the ground?'. The case study approach can offer additional insights into what gaps exist in its delivery or why one implementation strategy might be chosen over another. This in turn can help develop or refine theory, as shown in our study of the teaching of patient safety in undergraduate curricula (Table 4 )[ 6 , 10 ]. Key questions to consider when selecting the most appropriate study design are whether it is desirable or indeed possible to undertake a formal experimental investigation in which individuals and/or organisations are allocated to an intervention or control arm? Or whether the wish is to obtain a more naturalistic understanding of an issue? The former is ideally studied using a controlled experimental design, whereas the latter is more appropriately studied using a case study design.

Case studies may be approached in different ways depending on the epistemological standpoint of the researcher, that is, whether they take a critical (questioning one's own and others' assumptions), interpretivist (trying to understand individual and shared social meanings) or positivist approach (orientating towards the criteria of natural sciences, such as focusing on generalisability considerations) (Table 6 ). Whilst such a schema can be conceptually helpful, it may be appropriate to draw on more than one approach in any case study, particularly in the context of conducting health services research. Doolin has, for example, noted that in the context of undertaking interpretative case studies, researchers can usefully draw on a critical, reflective perspective which seeks to take into account the wider social and political environment that has shaped the case[ 11 ].

How are case studies conducted?

Here, we focus on the main stages of research activity when planning and undertaking a case study; the crucial stages are: defining the case; selecting the case(s); collecting and analysing the data; interpreting data; and reporting the findings.

Defining the case

Carefully formulated research question(s), informed by the existing literature and a prior appreciation of the theoretical issues and setting(s), are all important in appropriately and succinctly defining the case[ 8 , 12 ]. Crucially, each case should have a pre-defined boundary which clarifies the nature and time period covered by the case study (i.e. its scope, beginning and end), the relevant social group, organisation or geographical area of interest to the investigator, the types of evidence to be collected, and the priorities for data collection and analysis (see Table 7 )[ 1 ]. A theory driven approach to defining the case may help generate knowledge that is potentially transferable to a range of clinical contexts and behaviours; using theory is also likely to result in a more informed appreciation of, for example, how and why interventions have succeeded or failed[ 13 ].

For example, in our evaluation of the introduction of electronic health records in English hospitals (Table 3 ), we defined our cases as the NHS Trusts that were receiving the new technology[ 5 ]. Our focus was on how the technology was being implemented. However, if the primary research interest had been on the social and organisational dimensions of implementation, we might have defined our case differently as a grouping of healthcare professionals (e.g. doctors and/or nurses). The precise beginning and end of the case may however prove difficult to define. Pursuing this same example, when does the process of implementation and adoption of an electronic health record system really begin or end? Such judgements will inevitably be influenced by a range of factors, including the research question, theory of interest, the scope and richness of the gathered data and the resources available to the research team.

Selecting the case(s)

The decision on how to select the case(s) to study is a very important one that merits some reflection. In an intrinsic case study, the case is selected on its own merits[ 8 ]. The case is selected not because it is representative of other cases, but because of its uniqueness, which is of genuine interest to the researchers. This was, for example, the case in our study of the recruitment of minority ethnic participants into asthma research (Table 1 ) as our earlier work had demonstrated the marginalisation of minority ethnic people with asthma, despite evidence of disproportionate asthma morbidity[ 14 , 15 ]. In another example of an intrinsic case study, Hellstrom et al.[ 16 ] studied an elderly married couple living with dementia to explore how dementia had impacted on their understanding of home, their everyday life and their relationships.

For an instrumental case study, selecting a "typical" case can work well[ 8 ]. In contrast to the intrinsic case study, the particular case which is chosen is of less importance than selecting a case that allows the researcher to investigate an issue or phenomenon. For example, in order to gain an understanding of doctors' responses to health policy initiatives, Som undertook an instrumental case study interviewing clinicians who had a range of responsibilities for clinical governance in one NHS acute hospital trust[ 17 ]. Sampling a "deviant" or "atypical" case may however prove even more informative, potentially enabling the researcher to identify causal processes, generate hypotheses and develop theory.

In collective or multiple case studies, a number of cases are carefully selected. This offers the advantage of allowing comparisons to be made across several cases and/or replication. Choosing a "typical" case may enable the findings to be generalised to theory (i.e. analytical generalisation) or to test theory by replicating the findings in a second or even a third case (i.e. replication logic)[ 1 ]. Yin suggests two or three literal replications (i.e. predicting similar results) if the theory is straightforward and five or more if the theory is more subtle. However, critics might argue that selecting 'cases' in this way is insufficiently reflexive and ill-suited to the complexities of contemporary healthcare organisations.

The selected case study site(s) should allow the research team access to the group of individuals, the organisation, the processes or whatever else constitutes the chosen unit of analysis for the study. Access is therefore a central consideration; the researcher needs to come to know the case study site(s) well and to work cooperatively with them. Selected cases need to be not only interesting but also hospitable to the inquiry [ 8 ] if they are to be informative and answer the research question(s). Case study sites may also be pre-selected for the researcher, with decisions being influenced by key stakeholders. For example, our selection of case study sites in the evaluation of the implementation and adoption of electronic health record systems (see Table 3 ) was heavily influenced by NHS Connecting for Health, the government agency that was responsible for overseeing the National Programme for Information Technology (NPfIT)[ 5 ]. This prominent stakeholder had already selected the NHS sites (through a competitive bidding process) to be early adopters of the electronic health record systems and had negotiated contracts that detailed the deployment timelines.

It is also important to consider in advance the likely burden and risks associated with participation for those who (or the site(s) which) comprise the case study. Of particular importance is the obligation for the researcher to think through the ethical implications of the study (e.g. the risk of inadvertently breaching anonymity or confidentiality) and to ensure that potential participants/participating sites are provided with sufficient information to make an informed choice about joining the study. The outcome of providing this information might be that the emotive burden associated with participation, or the organisational disruption associated with supporting the fieldwork, is considered so high that the individuals or sites decide against participation.

In our example of evaluating implementations of electronic health record systems, given the restricted number of early adopter sites available to us, we sought purposively to select a diverse range of implementation cases among those that were available[ 5 ]. We chose a mixture of teaching, non-teaching and Foundation Trust hospitals, and examples of each of the three electronic health record systems procured centrally by the NPfIT. At one recruited site, it quickly became apparent that access was problematic because of competing demands on that organisation. Recognising the importance of full access and co-operative working for generating rich data, the research team decided not to pursue work at that site and instead to focus on other recruited sites.

Collecting the data

In order to develop a thorough understanding of the case, the case study approach usually involves the collection of multiple sources of evidence, using a range of quantitative (e.g. questionnaires, audits and analysis of routinely collected healthcare data) and more commonly qualitative techniques (e.g. interviews, focus groups and observations). The use of multiple sources of data (data triangulation) has been advocated as a way of increasing the internal validity of a study (i.e. the extent to which the method is appropriate to answer the research question)[ 8 , 18 – 21 ]. An underlying assumption is that data collected in different ways should lead to similar conclusions, and approaching the same issue from different angles can help develop a holistic picture of the phenomenon (Table 2 )[ 4 ].

Brazier and colleagues used a mixed-methods case study approach to investigate the impact of a cancer care programme[ 22 ]. Here, quantitative measures were collected with questionnaires before, and five months after, the start of the intervention which did not yield any statistically significant results. Qualitative interviews with patients however helped provide an insight into potentially beneficial process-related aspects of the programme, such as greater, perceived patient involvement in care. The authors reported how this case study approach provided a number of contextual factors likely to influence the effectiveness of the intervention and which were not likely to have been obtained from quantitative methods alone.

In collective or multiple case studies, data collection needs to be flexible enough to allow a detailed description of each individual case to be developed (e.g. the nature of different cancer care programmes), before considering the emerging similarities and differences in cross-case comparisons (e.g. to explore why one programme is more effective than another). It is important that data sources from different cases are, where possible, broadly comparable for this purpose even though they may vary in nature and depth.

Analysing, interpreting and reporting case studies

Making sense and offering a coherent interpretation of the typically disparate sources of data (whether qualitative alone or together with quantitative) is far from straightforward. Repeated reviewing and sorting of the voluminous and detail-rich data are integral to the process of analysis. In collective case studies, it is helpful to analyse data relating to the individual component cases first, before making comparisons across cases. Attention needs to be paid to variations within each case and, where relevant, the relationship between different causes, effects and outcomes[ 23 ]. Data will need to be organised and coded to allow the key issues, both derived from the literature and emerging from the dataset, to be easily retrieved at a later stage. An initial coding frame can help capture these issues and can be applied systematically to the whole dataset with the aid of a qualitative data analysis software package.

The Framework approach is a practical approach, comprising of five stages (familiarisation; identifying a thematic framework; indexing; charting; mapping and interpretation) , to managing and analysing large datasets particularly if time is limited, as was the case in our study of recruitment of South Asians into asthma research (Table 1 )[ 3 , 24 ]. Theoretical frameworks may also play an important role in integrating different sources of data and examining emerging themes. For example, we drew on a socio-technical framework to help explain the connections between different elements - technology; people; and the organisational settings within which they worked - in our study of the introduction of electronic health record systems (Table 3 )[ 5 ]. Our study of patient safety in undergraduate curricula drew on an evaluation-based approach to design and analysis, which emphasised the importance of the academic, organisational and practice contexts through which students learn (Table 4 )[ 6 ].

Case study findings can have implications both for theory development and theory testing. They may establish, strengthen or weaken historical explanations of a case and, in certain circumstances, allow theoretical (as opposed to statistical) generalisation beyond the particular cases studied[ 12 ]. These theoretical lenses should not, however, constitute a strait-jacket and the cases should not be "forced to fit" the particular theoretical framework that is being employed.

When reporting findings, it is important to provide the reader with enough contextual information to understand the processes that were followed and how the conclusions were reached. In a collective case study, researchers may choose to present the findings from individual cases separately before amalgamating across cases. Care must be taken to ensure the anonymity of both case sites and individual participants (if agreed in advance) by allocating appropriate codes or withholding descriptors. In the example given in Table 3 , we decided against providing detailed information on the NHS sites and individual participants in order to avoid the risk of inadvertent disclosure of identities[ 5 , 25 ].

What are the potential pitfalls and how can these be avoided?

The case study approach is, as with all research, not without its limitations. When investigating the formal and informal ways undergraduate students learn about patient safety (Table 4 ), for example, we rapidly accumulated a large quantity of data. The volume of data, together with the time restrictions in place, impacted on the depth of analysis that was possible within the available resources. This highlights a more general point of the importance of avoiding the temptation to collect as much data as possible; adequate time also needs to be set aside for data analysis and interpretation of what are often highly complex datasets.

Case study research has sometimes been criticised for lacking scientific rigour and providing little basis for generalisation (i.e. producing findings that may be transferable to other settings)[ 1 ]. There are several ways to address these concerns, including: the use of theoretical sampling (i.e. drawing on a particular conceptual framework); respondent validation (i.e. participants checking emerging findings and the researcher's interpretation, and providing an opinion as to whether they feel these are accurate); and transparency throughout the research process (see Table 8 )[ 8 , 18 – 21 , 23 , 26 ]. Transparency can be achieved by describing in detail the steps involved in case selection, data collection, the reasons for the particular methods chosen, and the researcher's background and level of involvement (i.e. being explicit about how the researcher has influenced data collection and interpretation). Seeking potential, alternative explanations, and being explicit about how interpretations and conclusions were reached, help readers to judge the trustworthiness of the case study report. Stake provides a critique checklist for a case study report (Table 9 )[ 8 ].

Conclusions

The case study approach allows, amongst other things, critical events, interventions, policy developments and programme-based service reforms to be studied in detail in a real-life context. It should therefore be considered when an experimental design is either inappropriate to answer the research questions posed or impossible to undertake. Considering the frequency with which implementations of innovations are now taking place in healthcare settings and how well the case study approach lends itself to in-depth, complex health service research, we believe this approach should be more widely considered by researchers. Though inherently challenging, the research case study can, if carefully conceptualised and thoughtfully undertaken and reported, yield powerful insights into many important aspects of health and healthcare delivery.

Yin RK: Case study research, design and method. 2009, London: Sage Publications Ltd., 4

Google Scholar  

Keen J, Packwood T: Qualitative research; case study evaluation. BMJ. 1995, 311: 444-446.

Article   CAS   PubMed   PubMed Central   Google Scholar  

Sheikh A, Halani L, Bhopal R, Netuveli G, Partridge M, Car J, et al: Facilitating the Recruitment of Minority Ethnic People into Research: Qualitative Case Study of South Asians and Asthma. PLoS Med. 2009, 6 (10): 1-11.

Article   Google Scholar  

Pinnock H, Huby G, Powell A, Kielmann T, Price D, Williams S, et al: The process of planning, development and implementation of a General Practitioner with a Special Interest service in Primary Care Organisations in England and Wales: a comparative prospective case study. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO). 2008, [ http://www.sdo.nihr.ac.uk/files/project/99-final-report.pdf ]

Robertson A, Cresswell K, Takian A, Petrakaki D, Crowe S, Cornford T, et al: Prospective evaluation of the implementation and adoption of NHS Connecting for Health's national electronic health record in secondary care in England: interim findings. BMJ. 2010, 41: c4564-

Pearson P, Steven A, Howe A, Sheikh A, Ashcroft D, Smith P, the Patient Safety Education Study Group: Learning about patient safety: organisational context and culture in the education of healthcare professionals. J Health Serv Res Policy. 2010, 15: 4-10. 10.1258/jhsrp.2009.009052.

Article   PubMed   Google Scholar  

van Harten WH, Casparie TF, Fisscher OA: The evaluation of the introduction of a quality management system: a process-oriented case study in a large rehabilitation hospital. Health Policy. 2002, 60 (1): 17-37. 10.1016/S0168-8510(01)00187-7.

Stake RE: The art of case study research. 1995, London: Sage Publications Ltd.

Sheikh A, Smeeth L, Ashcroft R: Randomised controlled trials in primary care: scope and application. Br J Gen Pract. 2002, 52 (482): 746-51.

PubMed   PubMed Central   Google Scholar  

King G, Keohane R, Verba S: Designing Social Inquiry. 1996, Princeton: Princeton University Press

Doolin B: Information technology as disciplinary technology: being critical in interpretative research on information systems. Journal of Information Technology. 1998, 13: 301-311. 10.1057/jit.1998.8.

George AL, Bennett A: Case studies and theory development in the social sciences. 2005, Cambridge, MA: MIT Press

Eccles M, the Improved Clinical Effectiveness through Behavioural Research Group (ICEBeRG): Designing theoretically-informed implementation interventions. Implementation Science. 2006, 1: 1-8. 10.1186/1748-5908-1-1.

Article   PubMed Central   Google Scholar  

Netuveli G, Hurwitz B, Levy M, Fletcher M, Barnes G, Durham SR, Sheikh A: Ethnic variations in UK asthma frequency, morbidity, and health-service use: a systematic review and meta-analysis. Lancet. 2005, 365 (9456): 312-7.

Sheikh A, Panesar SS, Lasserson T, Netuveli G: Recruitment of ethnic minorities to asthma studies. Thorax. 2004, 59 (7): 634-

CAS   PubMed   PubMed Central   Google Scholar  

Hellström I, Nolan M, Lundh U: 'We do things together': A case study of 'couplehood' in dementia. Dementia. 2005, 4: 7-22. 10.1177/1471301205049188.

Som CV: Nothing seems to have changed, nothing seems to be changing and perhaps nothing will change in the NHS: doctors' response to clinical governance. International Journal of Public Sector Management. 2005, 18: 463-477. 10.1108/09513550510608903.

Lincoln Y, Guba E: Naturalistic inquiry. 1985, Newbury Park: Sage Publications

Barbour RS: Checklists for improving rigour in qualitative research: a case of the tail wagging the dog?. BMJ. 2001, 322: 1115-1117. 10.1136/bmj.322.7294.1115.

Mays N, Pope C: Qualitative research in health care: Assessing quality in qualitative research. BMJ. 2000, 320: 50-52. 10.1136/bmj.320.7226.50.

Mason J: Qualitative researching. 2002, London: Sage

Brazier A, Cooke K, Moravan V: Using Mixed Methods for Evaluating an Integrative Approach to Cancer Care: A Case Study. Integr Cancer Ther. 2008, 7: 5-17. 10.1177/1534735407313395.

Miles MB, Huberman M: Qualitative data analysis: an expanded sourcebook. 1994, CA: Sage Publications Inc., 2

Pope C, Ziebland S, Mays N: Analysing qualitative data. Qualitative research in health care. BMJ. 2000, 320: 114-116. 10.1136/bmj.320.7227.114.

Cresswell KM, Worth A, Sheikh A: Actor-Network Theory and its role in understanding the implementation of information technology developments in healthcare. BMC Med Inform Decis Mak. 2010, 10 (1): 67-10.1186/1472-6947-10-67.

Article   PubMed   PubMed Central   Google Scholar  

Malterud K: Qualitative research: standards, challenges, and guidelines. Lancet. 2001, 358: 483-488. 10.1016/S0140-6736(01)05627-6.

Article   CAS   PubMed   Google Scholar  

Yin R: Case study research: design and methods. 1994, Thousand Oaks, CA: Sage Publishing, 2

Yin R: Enhancing the quality of case studies in health services research. Health Serv Res. 1999, 34: 1209-1224.

Green J, Thorogood N: Qualitative methods for health research. 2009, Los Angeles: Sage, 2

Howcroft D, Trauth E: Handbook of Critical Information Systems Research, Theory and Application. 2005, Cheltenham, UK: Northampton, MA, USA: Edward Elgar

Book   Google Scholar  

Blakie N: Approaches to Social Enquiry. 1993, Cambridge: Polity Press

Doolin B: Power and resistance in the implementation of a medical management information system. Info Systems J. 2004, 14: 343-362. 10.1111/j.1365-2575.2004.00176.x.

Bloomfield BP, Best A: Management consultants: systems development, power and the translation of problems. Sociological Review. 1992, 40: 533-560.

Shanks G, Parr A: Positivist, single case study research in information systems: A critical analysis. Proceedings of the European Conference on Information Systems. 2003, Naples

Pre-publication history

The pre-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2288/11/100/prepub

Download references

Acknowledgements

We are grateful to the participants and colleagues who contributed to the individual case studies that we have drawn on. This work received no direct funding, but it has been informed by projects funded by Asthma UK, the NHS Service Delivery Organisation, NHS Connecting for Health Evaluation Programme, and Patient Safety Research Portfolio. We would also like to thank the expert reviewers for their insightful and constructive feedback. Our thanks are also due to Dr. Allison Worth who commented on an earlier draft of this manuscript.

Author information

Authors and affiliations.

Division of Primary Care, The University of Nottingham, Nottingham, UK

Sarah Crowe & Anthony Avery

Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK

Kathrin Cresswell, Ann Robertson & Aziz Sheikh

School of Health in Social Science, The University of Edinburgh, Edinburgh, UK

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Sarah Crowe .

Additional information

Competing interests.

The authors declare that they have no competing interests.

Authors' contributions

AS conceived this article. SC, KC and AR wrote this paper with GH, AA and AS all commenting on various drafts. SC and AS are guarantors.

Rights and permissions

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0 ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and permissions

About this article

Cite this article.

Crowe, S., Cresswell, K., Robertson, A. et al. The case study approach. BMC Med Res Methodol 11 , 100 (2011). https://doi.org/10.1186/1471-2288-11-100

Download citation

Received : 29 November 2010

Accepted : 27 June 2011

Published : 27 June 2011

DOI : https://doi.org/10.1186/1471-2288-11-100

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Case Study Approach
• Electronic Health Record System
• Case Study Design
• Case Study Site
• Case Study Report

BMC Medical Research Methodology

ISSN: 1471-2288

• General enquiries: [email protected]

Case Study Analysis: Examples + How-to Guide & Writing Tips

A case study analysis is a typical assignment in business management courses. The task aims to show high school and college students how to analyze a current situation, determine what problems exist, and develop the best possible strategy to achieve the desired outcome.

Many students feel anxious about writing case analyses because being told to analyze a case study and provide a solution can seem like a big task. That is especially so when working with real-life scenarios. However, you can rest assured writing a case analysis paper is easier than you think. Just keep reading this article and you will find case study examples for students and the advice provided by Custom-writing experts!

• 👣 Main Steps
• 🕵 Preparing the Case

🔬 Analyzing the Case

• 📑 Format & Structure
• 🙅 Things to Avoid
• 🏁 Conclusion

🔗 References

👣 writing a case study analysis: main steps.

Business management is built on case analysis. Every single economic result shows that the methods and instruments employed were either well-timed and expedient, in the event of success, or not, in case of failure. These two options indicate whether the strategy is efficient (and should be followed) or requires corrections (or complete change). Such an approach to the case study will make your writing piece more proficient and valuable for the reader. The following steps will direct your plan for writing a case study analysis.

Step 1: Preliminary work

• Make notes and highlight the numbers and ideas that could be quoted.
• Single out as many problems as you can, and briefly mark their underlying issues. Then make a note of those responsible. In the report, you will use two to five of the problems, so you will have a selection to choose from.
• Outline a possible solution to each of the problems you found. Course readings and outside research shall be used here. Highlight your best and worst solution for further reference.

Step 2: Drafting the Case

• Provide a general description of the situation and its history.
• Name all the problems you are going to discuss.
• Specify the theory used for the analysis.
• Present the assumptions that emerged during the analysis, if any.
• Describe the detected problems in more detail.
• Indicate their link to, and effect on, the general situation.
• Explain why the problems emerged and persist.
• List realistic and feasible solutions to the problems you outlined, in the order of importance.
• Specify your predicted results of such changes.
• Support your choice with reliable evidence (i.e., textbook readings, the experience of famous companies, and other external research).
• Define the strategies required to fulfill your proposed solution.
• Indicate the responsible people and the realistic terms for its implementation.
• Recommend the issues for further analysis and supervision.

Step 3: Finalizing the Case

Like any other piece of writing, a case analysis requires post-editing. Carefully read it through, looking for inconsistencies and gaps in meaning. Your purpose is to make it look complete, precise, and convincing.

🕵 Preparing a Case for Analysis

Your professor might give you various case study examples from which to choose, or they may just assign you a particular case study. To conduct a thorough data analysis, you must first read the case study. This might appear to be obvious. However, you’d be surprised at how many students don’t take adequate time to complete this part.

Read the case study very thoroughly, preferably several times. Highlight, underline, flag key information, and make notes to refer to later when you are writing your analysis report.

If you don’t have a complete knowledge of the case study your professor has assigned, you won’t conduct a proper analysis of it. Even if you make use of a business case study template or refer to a sample analysis, it won’t help if you aren’t intimately familiar with your case study.

You will also have to conduct research. When it comes to research, you will need to do the following:

• Gather hard, quantitative data (e.g. 67% of the staff participated in the meeting).
• Design research tools , such as questionnaires and surveys (this will aid in gathering data).
• Determine and suggest the best specific, workable solutions.

It would be best if you also learned how to analyze a case study. Once you have read through the case study, you need to determine the focus of your analysis. You can do this by doing the following:

Compare your chosen solutions to the solutions offered by the experts who analyzed the case study you were given or to online assignments for students who were dealing with a similar task. The experts’ solutions will probably be more advanced than yours simply because these people are more experienced. However, don’t let this discourage you; the whole point of doing this analysis is to learn. Use the opportunity to learn from others’ valuable experience, and your results will be better next time.

If you are still in doubt, the University of South Carolina offers a great guide on forming a case study analysis.

📑 Case Analysis Format & Structure

When you are learning how to write a case study analysis, it is important to get the format of your analysis right. Understanding the case study format is vital for both the professor and the student. The person planning and handing out such an assignment should ensure that the student doesn’t have to use any external sources .

In turn, students have to remember that a well-written case analysis provides all the data, making it unnecessary for the reader to go elsewhere for information.

Regardless of whether you use a case study template, you will need to follow a clear and concise format when writing your analysis report. There are some possible case study frameworks available. Still, a case study should contain eight sections laid out in the following format:

• Describe the purpose of the current case study;
• Provide a summary of the company;
• Briefly introduce the problems and issues found in the case study
• Discuss the theory you will be using in the analysis;
• Present the key points of the study and present any assumptions made during the analysis.
• Present each problem you have singled out;
• Justify your inclusion of each problem by providing supporting evidence from the case study and by discussing relevant theory and what you have learned from your course content;
• Divide the section (and following sections) into subsections, one for each of your selected problems.
• Present a summary of each problem you have identified;
• Present plausible solutions for each of the problems, keeping in mind that each problem will likely have more than one possible solution;
• Provide the pros and cons of each solution in a way that is practical.
• Conclusion . This is a summary of your findings and discussion.
• Decide which solution best fits each of the issues you identified;
• Explain why you chose this solution and how it will effectively solve the problem;
• Be persuasive when you write this section so that you can drive your point home;
• Be sure to bring together theory and what you have learned throughout your course to support your recommendations.
• Provide an explanation of what must be done, who should take action, and when the solution should be carried out;
• Where relevant, you should provide an estimate of the cost in implementing the solution, including both the financial investment and the cost in terms of time.
• References. While you generally do not need to refer to many external sources when writing a case study analysis, you might use a few. When you do, you will need to properly reference these sources, which is most often done in one of the main citation styles, including APA, MLA, or Harvard. There is plenty of help when citing references, and you can follow these APA guidelines , these MLA guidelines , or these Harvard guidelines .
• Appendices. This is the section you include after your case study analysis if you used any original data in the report. These data, presented as charts, graphs, and tables, are included here because to present them in the main body of the analysis would be disruptive to the reader. The University of Southern California provides a great description of appendices and when to make use of them.

When you’ve finished your first draft, be sure to proofread it. Look not only for potential grammar and spelling errors but also for discrepancies or holes in your argument.

You should also know what you need to avoid when writing your analysis.

🙅 Things to Avoid in Case Analysis

Whenever you deal with a case study, remember that there are some pitfalls to avoid! Beware of the following mistakes:

• Excessive use of colloquial language . Even though it is a study of an actual case, it should sound formal.
• Lack of statistical data . Give all the important data, both in percentages and in numbers.
• Excessive details. State only the most significant facts, rather than drowning the reader in every fact you find.
• Inconsistency in the methods you have used . In a case study, theory plays a relatively small part, so you must develop a specific case study research methodology.
• Trivial means of research . It is critical that you design your own case study research method in whatever form best suits your analysis, such as questionnaires and surveys.

It is useful to see a few examples of case analysis papers. After all, a sample case study report can provide you with some context so you can see how to approach each aspect of your paper.

👀 Case Study Examples for Students

It might be easier to understand how a case study analysis works if you have an example to look at. Fortunately, examples of case studies are easy to come by. Take a look at this video for a sample case study analysis for the Coca-Cola Company.

If you want another example, then take a look at the one below!

Business Case Analysis: Example

CRM’s primary focus is customers and customer perception of the brand or the company. The focus may shift depending on customers’ needs. The main points that Center Parcs should consider are an increase in customer satisfaction and its market share. Both of these points will enhance customer perception of the product as a product of value. Increased customer satisfaction will indicate that the company provides quality services, and increased market share can reduce the number of switching (or leaving) customers, thus fostering customer loyalty.

Case Study Topics

• Equifax case study: the importance of cybersecurity measures. 
• Study a case illustrating ethical issues of medical research.
• Examine the case describing the complications connected with nursing and residential care.
• Analyze the competitive strategy of Delta Airlines .
• Present a case study of an ethical dilemma showing the conflict between the spirit and the letter of the law.  
• Explore the aspects of Starbucks’ marketing strategyin a case study.  
• Research a case of community-based clinic organization and development.
• Customer service of United Airlines: a case study .
• Analyze a specific schizophrenia case and provide your recommendations.
• Provide a case study of a patient with hyperglycemia.
• Examine the growth strategy of United Healthcare.
• Present a case study demonstrating ethical issues in business.
• Study a case of the 5% shareholding rule application and its impact on the company.
• Case study of post-traumatic stress disorder .
• Analyze a case examining the issues of cross-cultural management .
• Write a case study exploring the ethical issues the finance manager of a long-term care facility can face and the possible reaction to them.
• Write a case study analyzing the aspects of a new president of a firm election.
• Discuss the specifics of supply chain management in the case of Tehindo company.
• Study a case of a life crisis in a family and the ways to cope with it.
• Case study of Tea Leaves and More: supply chain issues.   
• Explore the case of ketogenic diet implementation among sportspeople.  
• Analyze the case of Webster Jewelry shop and suggest some changes.  
• Examine the unique aspects of Tea and More brand management.  
• Adidas case study: an ethical dilemma .
• Research the challenges of Brazos Valley Food Bank and suggest possible solutions.  
• Describe the case of dark web monitoring for business.  
• Study a case of permissive parenting style .
• Case study of Starbucks employees.
• Analyze a case of workplace discrimination and suggest a strategy to avoid it.
• Examine a case of the consumer decision-making process and define the factors that influence it.
• Present a case study of Netflix illustrating the crucial role of management innovation for company development.  
• Discuss a case describing a workplace ethical issue and propose ways to resolve it.
• Case study of the 2008 financial crisis: Graham’s value investing principles in the modern economic climate.
• Write a case study analyzing the harmful consequences of communication issues in a virtual team.
• Analyze a case that highlights the importance of a proper functional currency choice. 
• Examine the case of Hitachi Power Systems management.  
• Present a case study of medication research in a healthcare facility.
• Study the case of Fiji Water and the challenges the brand faces.  
• Research a social problem case and suggest a solution.
• Analyze a case that reveals the connection between alcohol use and borderline personality disorder.
• Transglobal Airline case study: break-even analysis.
• Examine the case of Chiquita Brands International from the moral and business ethics points of view.
• Present a case study of applying for Social Security benefits. 
• Study the case of a mass hacker attack on Microsoft clients and suggest possible ways to prevent future attacks.
• Case study of leadership effectiveness. 
• Analyze a case presenting a clinical moral dilemma and propose ways to resolve it. 
• Describe the case of Cowbell Brewing Company and discuss the strategy that made them successful.
• Write a case study of WeWork company and analyze the strengths and weaknesses of its strategy.
• Case study of medical ethical decision-making.
• Study the case of The Georges hotel and suggest ways to overcome its managerial issues.

🏁 Concluding Remarks

Writing a case study analysis can seem incredibly overwhelming, especially if you have never done it before. Just remember, you can do it provided you follow a plan, keep to the format described here, and study at least one case analysis example.

If you still need help analyzing a case study, your professor is always available to answer your questions and point you in the right direction. You can also get help with any aspect of the project from a custom writing company. Just tackle the research and hand over the writing, write a rough draft and have it checked by a professional, or completely hand the project off to an expert writer.

Regardless of the path you choose, you will turn in something of which you can be proud!

✏️ Case Study Analysis FAQ

Students (especially those who study business) often need to write a case study analysis. It is a kind of report that describes a business case. It includes multiple aspects, for example, the problems that exist, possible solutions, forecasts, etc.

There should be 3 main points covered in a case study analysis:

• The challenge(s) description,
• Possible solutions,
• Outcomes (real and/or foreseen).

Firstly, study some examples available online and in the library. Case study analysis should be a well-structured paper with all the integral components in place. Thus, you might want to use a template and/or an outline to start correctly.

A case study analysis is a popular task for business students. They typically hand it in the format of a paper with several integral components:

• Description of the problem
• Possible ways out
• Results and/or forecasts

Students sometimes tell about the outcome of their research within an oral presentation.

• Case Study: Academia
• Windows of vulnerability: a case study analysis (IEEE)
• A (Very) Brief Refresher on the Case Study Method: SAGE
• The case study approach: Medical Research Methodology
• Strengths and Limitations of Case Studies: Stanford University
• A Sample APA Paper: Radford University
• How to Write a Case Study APA Style: Seattle PI
• The Case Analysis: GVSU
• How to Outline: Purdue OWL
• Incorporating Interview Data: UW-Madison Writing Center
• Share to Facebook
• Share to LinkedIn
• Share to email

If you are a student, you might need to learn how to write a literature review at some point. But don’t think it’s the same as the book review or other types of academic writing you had to do in high school! A literature review is a close examination of...

So, have you been recently assigned a research project? Or, even worse, is it already due soon? The following research paper hacks will help you do it in record time. In the article, you’ll see ten things you can do to conduct a study and compose a piece like a...

Eating a delicacy, watching a good movie, and proving a point to an audience are the three things that make life seem better. Today, you’ll deal with the last one. You’re about to become a professional at public speaking and attention grabbing. Here, you can learn how to write a...

What is a library research paper? It’s nothing more than an academic writing project that summarizes the information on a specific topic taken from primary and secondary sources. There are numerous library research examples you can find online. But to complete this assignment, you should simply follow these essential steps:...

Do you need to write a research analysis paper but have no idea how to do that? Then you’re in the right place. While completing this type of assignment, your key aim is to critically analyze a research article. An article from a serious scientific journal would be a good...

American Antiquity is a professional quarterly journal, which contains various papers on the American archeology. It is incredibly popular among archeologists and the students majoring in history. The organization adopted the rules of The Society for American Archaeology (SAA) citation style. As a result: The journal includes numerous references that...

The most tedious and time-consuming part of any school or college written assignment is the bibliography. Sometimes, it can even be challenging! For example, if you’re confused by the variety of citation styles. That is why Custom-Writing experts prepared a brief guide about creating a perfect bibliography for a project....

An appendix is the part of the paper that contains supplementary material. The information from an appendix in paper writing is not essential. If the readers ignore this part, they still have to get the paper’s idea. Appendices help the readers to understand the research better. They might be useful...

Writing an abstract is one of the skills you need to master to succeed in your studies. An abstract is a summary of an academic text. It contains information about the aims and the outcomes of the research. The primary purpose of an abstract is to help readers understand what...

So you have to write a literature review. You find your favorite novel and then start analyzing it. This is how it’s usually done, right? It’s not. You have to learn the elements of literature review and how to deal with them.

Only two words, but you already feel a chill down your spine. A research paper is no joke. It’s a super detailed piece of academic writing where you analyze a chosen issue in-depth. The main aim of such torture is to show how knowledgeable you are and that your opinion...

A research proposal is a text that suggests a topic or research problem, justifies the need to study it, and describes the ways and methods of conducting the study. Scholars usually write proposals to get funding for their research. In their turn, students might have to do that to get...

Quite an impressive piece The steps and procedures outlined here are well detailed and the examples facilitates understanding.

it was very helpful. I have an assessment to write where in I need to mention different effective components that are needed to compile a high quality case study assessment.

It is very important and helpful.

Thanks a lot. A knowledge shared with a structured template. Stay the course

Thanks for this valuable knowledge.I loved this. keep sharing. to know more about click Air India Case Study – Why Air India failed ?

This is going to be a great help in my monthly analysis requirements for my subject. Thank you so much.

Thank you very much for this insightful guidelines… It has really been a great tool for writing my project. Thanks once again.

This article was very helpful, even though I’ll have a clearer mind only after I do the case study myself but I felt very much motivated after reading this, as now I can at least have a plan of what to do compared to the clueless me I was before I read it. I hope if I have any questions or doubts about doing a case study I can clear it out here.

Log in using your username and password

• Search More Search for this keyword Advanced search
• Latest content
• Current issue
• Write for Us
• BMJ Journals

You are here

• Volume 21, Issue 1
• What is a case study?
• Article Text
• Article info
• Citation Tools
• Rapid Responses
• Article metrics

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

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

Statistics from Altmetric.com

Request permissions.

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

What is it?

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

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

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

Benefits and limitations of case studies

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

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

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

Examples of case studies

Example 1: nurses’ paediatric pain management practices.

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

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

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

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

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

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

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

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

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

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

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

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

• Gustafsson J
• Calanzaro M
• Sandelowski M

Competing interests None declared.

Provenance and peer review Commissioned; internally peer reviewed.

Read the full text or download the PDF:

Advertisement

Supported by

Did an Unorthodox Therapist Drive a Woman to Suicide?

“Case Study,” by Graeme Macrae Burnet, is a novel of found documents detailing troubled lives and shifting identities.

• Share full article

By Christian Lorentzen

• Apple Books
• Barnes and Noble
• Books-A-Million
• Bookshop.org

When you purchase an independently reviewed book through our site, we earn an affiliate commission.

CASE STUDY, by Graeme Macrae Burnet

To get to Primrose Hill from central London, you take the Tube to Chalk Farm Station, exit to your right toward a cafe and an off-license, and climb a path to an overpass above train tracks. The path is called, rather unassumingly, Bridge Approach, and a five-minute walk leads to Primrose Hill. I happened to live in these parts for three years, and I crossed the overpass twice a day most days. Just to the south is the Pembroke Castle pub, where Liam Gallagher of Oasis was once arrested, in 1998. Another neighborhood tippler, Kingsley Amis, favored the Queen’s at the corner of St. George’s Terrace, according to his biographer Zachary Leader, who printed his monthly tab. From my balcony I could see the phone box where Sylvia Plath would desperately call Ted Hughes at his lover’s flat in her last days. It is a quiet neighborhood, but one dense with intrigue and peopled by famous, messy and tortured artistic personages.

The events of Graeme Macrae Burnet’s fourth novel, “Case Study,” are set off by a suicide in the 1960s by a young woman named Veronica, who jumps from the Bridge Approach overpass and is struck by the 4:45 train to High Barnet. (I am not sure that High Barnet trains, rather than Edgware-bound ones, run on this track, nor that the overpass itself, rather than just the path that approaches it, is called Bridge Approach, but these are the sorts of possible slight inaccuracies that Burnet and his not entirely reliable narrators relish.) An investigation into Veronica’s death and the man who might have been responsible for it — her therapist, Arthur Collins Braithwaite, whose office is on Primrose Hill — forms the substance of the narrative. Like Burnet’s previous novel, “ His Bloody Project ” (2016), “Case Study” was nominated for the Booker Prize and consists largely of purportedly found documents.

The would-be Miss Marple of Burnet’s loopy detective story is Veronica’s unnamed younger sister, who, under the alias Rebecca Smyth, becomes Braithwaite’s patient to find out if he drove Veronica to take her own life. Rebecca details her five sessions in notebooks that decades later end up in the hands of a writer named GMB, our frame narrator, who is researching Braithwaite for a potential biography. Now cast into obscurity, the (fictional) therapist was once a figure of note, appearing on BBC chat shows and publishing the books “Untherapy,” a best seller, and “Kill Your Self,” which Rebecca calls “a jumble of incomprehensible sentences, each having no discernible relationship to its neighbors.” Still, we are told by GMB, “Kill Your Self” “captured the zeitgeist,” acquired for its author a cult following from which he drew a lucrative pool of patients, and “if anything, the impenetrability of certain passages only served to confirm the author’s genius.”

“Case Study” consists of a preface, in which GMB explains how he received the notebooks (from Rebecca’s cousin, who noticed a blog post by GMB on Braithwaite); the five notebooks themselves, one of which includes a chapter clipped from “Untherapy” about a patient who is clearly Veronica; five biographical chapters about Braithwaite by GMB, inserted between the notebooks; and a postscript, in which GMB ventures south to pay a visit to the Pembroke Castle. The elegant nested structure is one of the novel’s chief appeals. So is the contrast between Rebecca’s narrative voice, characterized by what GMB calls “a certain kooky élan,” and the cool tone of GMB’s Life of Braithwaite. What emerges is a comedy of identities tried on and discarded. Given the number of suicides that mark the story, it’s a comedy with dark underpinnings.

Rebecca lives with her father, a retired engineer, and their housekeeper, and works as a receptionist for a talent agent. Her mother died when she was 15, falling off a cliff before her eyes, during a family holiday in Devon. Given that Rebecca is the only witness to the fall, and that she admits to fantasizing about pushing someone off the cliff the sentence before recounting her mother’s death, we can’t help suspecting that she might have done it herself. But we have no more reason to doubt it than the rest of her story, and that’s part of the fun: The whole tale might be a hoax.

We are having trouble retrieving the article content.

Please enable JavaScript in your browser settings.

Thank you for your patience while we verify access. If you are in Reader mode please exit and  log into  your Times account, or  subscribe  for all of The Times.

Thank you for your patience while we verify access.

Already a subscriber?  Log in .

Want all of The Times?  Subscribe .

Physical Review B

Covering condensed matter and materials physics.

• Collections
• Editorial Team
• Accepted Paper

Projective fixed points for non-Fermi liquids: A case study of the Ising-nematic quantum critical metal

Phys. rev. b, shubham kukreja, afshin besharat, and sung-sik lee.

In metals, low-energy effective theories are characterized by a set of coupling functions. Among them, the angle-dependent Fermi momentum specifies the size and shape of Fermi surface. Since the size of Fermi momentum grows incessantly relative to an energy scale that is lowered under the renormalization group (RG) flow, a metallic fixed point is defined only modulo a rescaling of Fermi momentum. In this paper, we discuss the physical consequences of this projective nature of fixed points for non-Fermi liquids with hot Fermi surfaces. The first is the absence of a unique dynamical critical exponent that dictates the relative scaling between energy and momentum across all low-energy observables. The second is mismatches between the scaling dimensions of couplings and their relevancy. Nonetheless, each projective fixed point is characterized by a few marginal and relevant coupling functions, and the notion of universality survives. We illustrate our findings by charting the space of projective fixed points and extracting their universal properties for the Ising-nematic quantum critical metal beyond the patch theory. To approach the interacting theory in two space dimensions from a controlled limit, we use the dimensional regularization scheme that tunes the co-dimension of Fermi surface as a control parameter. Near the upper critical dimension, two exactly marginal coupling functions span the space of stable projective fixed points: one specifies the shape of the Fermi surface and the other sets the angle-dependent Fermi velocity. All other coupling functions, including the Landau functions and the universal pairing interaction, are fixed by those two marginal functions. As the space dimension is lowered, vertex corrections alter the fate of the four-fermion coupling in a channel-dependent way. To the leading order, the forward scattering remains irrelevant while the pairing interaction becomes relevant near two dimensions. In two dimensions, it is expected that the universal superconducting fluctuations lower the symmetry of the non-Fermi liquid realized above the superconducting transition temperatures from the loop U(1) group to a proper subgroup.

Sign up to receive regular email alerts from Physical Review B

• Forgot your username/password?
• Create an account

Article Lookup

Paste a citation or doi, enter a citation.

‘Table 17’ Off Broadway Review: A Case Study in How to Steal a Show From the Leads

The featured actor Michael Rishawn makes a new rom-com by Douglas Lyons worth seeing

“Never work with animals or children.”

W.C. Fields delivered those words of wisdom to adult actors, and if the great screen comic were alive today, he might add to that short list of taboos a young actor’s name: Michael Rishawn. He walks away with the new Douglas Lyons comedy “Table 17” even though he’s a supporting player. The play had its world premiere Friday at MCC Theater.

Rishawn’s achievement is even greater when you consider that he’s on stage a lot with Kara Young, a veteran scene-stealer who recently won a Tony for her spectacularly insane performance in “Purlie Victorious” on Broadway last season.

Young and Biko Eisen-Martin play extranged lovers in “Table 17” who are about to meet again for a date that’s really not a date. When we first meet them separately, Young’s Jada worries about wearing the right outfit. Eisen-Martin’s Dallas repeats how Holly Hunter applied body fragrance in “Broadcast News.” These two opening vignettes are fun in a “Same Time, Next Year” sort of way that hasn’t been seen on stage, especially an Off Broadway stage, in decades.

Then Rishawn shows up. He’s the lucky actor who not only gets to play three featured roles but make several costume changes; the stunning outfits are by Devario D. Simmons. Rishawn plays the gay maître-d at a restaurant where Jada and Dallas are about to appear. The word “pissy” doesn’t begin to describe his portrayal. He follows that later in “Table 17” by playing a stud of a bartender and then a flight attendant whose major attribute is that he’s not gay, and when he opens his shirt, his pecs are D cup plus. Only this flight attendant character really figures into the plot, which gives the full trajectory of Jada and Dallas’ messy love affair.

When Rishawn is off the stage, you wait for him to return. The more we see of Jada and Dallas, the less we want to. Their relationship features very stale problems having to do with infidelity and career ambitions. The more the flight attendant becomes part of that relationship’s demise, even the talented Rishawn can’t keep from getting bogged down in the suds of a rom-com that turns into pure soap opera.

Lyons also wrote “Chicken & Biscuits.” In my review of that 2022 Broadway comedy, I wrote: “Among the heart-felt confessions of disinheritance and eating disorders, there’s a chat about why calling a homosexual man ‘a white boy’ is an act of grace.”

Lyons has more interesting things to say about gays in “Table 17.” With his gay maître-d character, he equates homosexuality with inherent loneliness. My suggestion to this tragically single restaurant host is simple: when Rishawn plays gay, he should take a tip from the flight-attendant side of his brain and show off those cut abs and enormous chest as often as possible. He will be lonely no more.

Zhailon Levingston directs.

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

This site uses Akismet to reduce spam. Learn how your comment data is processed .

Stop or yield? New research supports law change for cyclists

Oregon state university study shows that allowing cyclists to yield at stop signs does not increase danger.

Social Sharing

Cycling advocates in British Columbia hope a new U.S. study will boost the case to allow bicyclists to yield at stop signs and safely roll through intersections.

While it's the law in jurisdictions like B.C. for cyclists to stop at stop signs, like every other road user, it's common to see people on two wheels opt for an illegal yield — rolling past the sign after checking it's safe to proceed.

"It makes it a lot more efficient," said Vancouver cyclist Ben Cooper about getting through intersections. "I'm not going to come to a full stop. Like, the amount of energy it takes to stop my entire bike and get it going again — it just doesn't make sense."

The debate over whether rolling stops for cyclists should be enshrined in law has been ongoing since the early 1980s when Idaho first made it legal, resulting in the manoeuvre being named the Idaho stop.

• Winnipeggers rallying for 'Idaho stop' law that would let cyclists slow roll through stop signs

Several other U.S. states have since followed suit, including B.C.'s Pacific Northwest neighbours of Washington and Oregon. No jurisdiction in Canada has yet adopted laws for rolling stops for bikes.

Cycling advocates in B.C. say they've been pushing the issue for years and hope a new study from researchers at Oregon State University, published this month in an academic transportation journal, will aid their argument.

"It is going at a very slow pace and we need to take dramatic, bold steps that will enable us to reform these outdated laws and have more people … cycling," said Navdeep Chhina, director of campaigns and inclusion with Metro Vancouver's HUB Cycling .

New study supports laws that allow cyclists to yield at stop signs

The Oregon study says  with proper education for both cyclists and drivers, Idaho stops do not lead either riders or motorists to act unsafely.

One of the study's authors said they wanted to look at how well rolling-stop laws work, in a change from other studies that have looked at crash-data analysis and why riders yield at stop signs rather than stop as per the law.

"It required fully connecting two independent simulators, running subjects in pairs simultaneously and having each subject interacting with an avatar of the other in a shared virtual world," said David Hurwitz, a transportation engineering professor,  in a release  about the study.

Researchers observed 60 people paired off who went through 16 virtual interaction scenarios as either a cyclist or motorist, coming together at a four-way-stop intersection.

They found that instead of drivers being aggressive toward cyclists who appeared to be breaking the law by rolling through, driving participants approached intersections either more slowly or at a similar pace after being educated about what bicycle rolling stops were.

Cyclists, after also being taught about Idaho stops, preferred to yield rather than stop and went through intersections faster, meaning they spent less time in the intersection exposed to potential danger.

Nearly four out of five crashes involving cyclists in B.C. happen at intersections , according to ICBC.

Hurwitz said the study's findings suggest more work should be done by jurisdictions over the utility of rolling-stop laws.

"This research gives decision-makers information to support prospective legislative policies, set up educational programs and design robust enforcement practices," he said.

• B.C. sets minimum distance for drivers passing vulnerable road users

B.C.'s Ministry of Transportation is not rejecting the idea that Idaho stops could be made legal, but it said in a statement that more research would be required "to consider how the change would affect the safety of all road users."

In the meantime, it's reminding cyclists to come to a complete stop at a stop sign to ensure safety for the rider and all other road users.

ABOUT THE AUTHOR

Chad Pawson is a CBC News reporter in Vancouver. Please contact him at [email protected].

• On Instagram

Related Stories

• Top stories from British Columbia
• Man charged after Vancouver attacks that left 1 dead, 1 injured
• Flush toilets to soon arrive at large construction sites across B.C.
• Growing number of ex-B.C. United candidates to run as Independent

Information

• Author Services

Initiatives

You are accessing a machine-readable page. In order to be human-readable, please install an RSS reader.

All articles published by MDPI are made immediately available worldwide under an open access license. No special permission is required to reuse all or part of the article published by MDPI, including figures and tables. For articles published under an open access Creative Common CC BY license, any part of the article may be reused without permission provided that the original article is clearly cited. For more information, please refer to https://www.mdpi.com/openaccess .

Feature papers represent the most advanced research with significant potential for high impact in the field. A Feature Paper should be a substantial original Article that involves several techniques or approaches, provides an outlook for future research directions and describes possible research applications.

Feature papers are submitted upon individual invitation or recommendation by the scientific editors and must receive positive feedback from the reviewers.

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

Original Submission Date Received: .

• Active Journals
• Find a Journal
• Proceedings Series
• For Authors
• For Reviewers
• For Editors
• For Librarians
• For Publishers
• For Societies
• For Conference Organizers
• Open Access Policy
• Institutional Open Access Program
• Special Issues Guidelines
• Editorial Process
• Research and Publication Ethics
• Article Processing Charges
• Testimonials
• Preprints.org
• SciProfiles
• Encyclopedia

Article Menu

• Subscribe SciFeed
• Google Scholar
• on Google Scholar
• Table of Contents

Find support for a specific problem in the support section of our website.

Please let us know what you think of our products and services.

Visit our dedicated information section to learn more about MDPI.

JSmol Viewer

The state-of-the-art of mycobacterium chimaera infections and the causal link with health settings: a systematic review.

1. Introduction

2. materials and methods, 4. discussion, 4.1. mycobacterium chimaera’s characteristics and ecosystem, 4.2. heater-cooler units, medical devices, water, and air-conditioned implants, 4.3. incubation period and symptoms presentation, 4.4. presence in the lung system, 4.5. modality of transmission, 4.6. detection, 4.7. disinfection, 4.8. causal link assessment, 5. limitations, 6. conclusions, supplementary materials, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest, abbreviations.

• Vendramin, I.; Peghin, M.; Tascini, C.; Livi, U. Longest Incubation Period of Mycobacterium chimaera Infection after Cardiac Surgery. Eur. J. Cardio-Thoracic Surg. 2021 , 59 , 506–508. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Biswas, M.; Rahaman, S.; Biswas, T.K.; Haque, Z.; Ibrahim, B. Association of Sex, Age, and Comorbidities with Mortality in COVID-19 Patients: A Systematic Review and Meta-Analysis. Intervirology 2020 , 64 , 36–47. [ Google Scholar ] [ CrossRef ]
• Treglia, M.; Pallocci, M.; Passalacqua, P.; Sabatelli, G.; De Luca, L.; Zanovello, C.; Messineo, A.; Quintavalle, G.; Cisterna, A.M.; Marsella, L.T. Medico-Legal Aspects of Hospital-Acquired Infections: 5-Years of Judgements of the Civil Court of Rome. Healthcare 2022 , 10 , 1336. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Bolcato, V.; Tronconi, L.P.; Odone, A.; Blandi, L. Healthcare-Acquired Sars-Cov-2 Infection: A Viable Legal Category? Int. J. Risk Saf. Med. 2023 , 34 , 129–134. [ Google Scholar ] [ CrossRef ]
• Tattoli, L.; Dell’erba, A.; Ferorelli, D.; Gasbarro, A.; Solarino, B. Sepsis and Nosocomial Infections: The Role of Medico-Legal Experts in Italy. Antibiotics 2019 , 8 , 199. [ Google Scholar ] [ CrossRef ]
• Barranco, R.; Caristo, I.; Spigno, F.; Ponzano, M.; Trevisan, A.; Signori, A.; Di Biagio, A.; Ventura, F. Management of the Medico-Legal Dispute of Healthcare-Related SARS-CoV-2 Infections: Evaluation Criteria and Case Study in a Large University Hospital in Northwest Italy from 2020 to 2021. Int. J. Environ. Res. Public Health 2022 , 19 , 16764. [ Google Scholar ] [ CrossRef ]
• Goldenberg, S.D.; Volpé, H.; French, G.L. Clinical Negligence, Litigation and Healthcare-Associated Infections. J. Hosp. Infect. 2012 , 81 , 156–162. [ Google Scholar ] [ CrossRef ]
• Rizzo, N. La Causalità Civile ; Jus Civile; Giappichelli Editore: Torino, Italy, 2022. [ Google Scholar ]
• Riccardi, N.; Monticelli, J.; Antonello, R.M.; Luzzati, R.; Gabrielli, M.; Ferrarese, M.; Codecasa, L.; Di Bella, S.; Giacobbe, D.R. Mycobacterium chimaera Infections: An Update. J. Infect. Chemother. 2020 , 26 , 199–205. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Natanti, A.; Palpacelli, M.; Valsecchi, M.; Tagliabracci, A.; Pesaresi, M. Mycobacterium chimaera : A Report of 2 New Cases and Literature Review. Int. J. Leg. Med. 2021 , 135 , 2667–2679. [ Google Scholar ] [ CrossRef ]
• Wetzstein, N.; Kohl, T.A.; Diricks, M.; Mas-Peiro, S.; Holubec, T.; Kessel, J.; Graf, C.; Koch, B.; Herrmann, E.; Vehreschild, M.J.G.T.; et al. Clinical Characteristics and Outcome of Mycobacterium chimaera Infections after Cardiac Surgery: Systematic Review and Meta-Analysis of 180 Heater-Cooler Unit-Associated Cases. Clin. Microbiol. Infect. 2023 , 29 , 1008–1014. [ Google Scholar ] [ CrossRef ]
• Desai, A.N.; Hurtado, R.M. Infections and Outbreaks of Nontuberculous Mycobacteria in Hospital Settings. Curr. Treat. Options Infect. Dis. 2018 , 10 , 169–181. [ Google Scholar ] [ CrossRef ]
• van Ingen, J.; Kohl, T.A.; Kranzer, K.; Hasse, B.; Keller, P.M.; Katarzyna Szafrańska, A.; Hillemann, D.; Chand, M.; Schreiber, P.W.; Sommerstein, R.; et al. Global Outbreak of Severe Mycobacterium chimaera Disease after Cardiac Surgery: A Molecular Epidemiological Study. Lancet Infect. Dis. 2017 , 17 , 1033–1041. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Bisognin, F.; Messina, F.; Butera, O.; Nisii, C.; Mazzarelli, A.; Cristino, S.; Pascale, M.R.; Lombardi, G.; Cannas, A.; Dal Monte, P. Investigating the Origin of Mycobacterium chimaera Contamination in Heater-Cooler Units: Integrated Analysis with Fourier Transform Infrared Spectroscopy and Whole-Genome Sequencing. Microbiol. Spectr. 2022 , 10 , e0289322. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Pinzauti, D.; De Giorgi, S.; Fox, V.; Lazzeri, E.; Messina, G.; Santoro, F.; Iannelli, F.; Ricci, S.; Pozzi, G. Complete Genome Sequences of Mycobacterium chimaera Strains 850 and 852, Isolated from Heater-Cooler Unit Water. Microbiol. Resour. Announc. 2022 , 11 , e0102121. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Hasan, N.A.; Warren, R.L.; Elaine Epperson, L.; Malecha, A.; Alexander, D.C.; Turenne, C.Y.; MacMillan, D.; Birol, I.; Pleasance, S.; Coope, R.; et al. Complete Genome Sequence of Mycobacterium chimaera SJ42, a Nonoutbreak Strain from an Immunocompromised Patient with Pulmonary Disease. Genome Announc. 2017 , 5 , e00963-17. [ Google Scholar ] [ CrossRef ]
• Wallace, R.J.; Iakhiaeva, E.; Williams, M.D.; Brown-Elliott, B.A.; Vasireddy, S.; Vasireddy, R.; Lande, L.; Peterson, D.D.; Sawicki, J.; Kwait, R.; et al. Absence of Mycobacterium Intracellulare and Presence of Mycobacterium chimaera in Household Water and Biofilm Samples of Patients in the United States with Mycobacterium avium Complex Respiratory Disease. J. Clin. Microbiol. 2013 , 51 , 1747–1752. [ Google Scholar ] [ CrossRef ]
• Falkinham, J.O.; Hilborn, E.D.; Arduino, M.J.; Pruden, A.; Edwards, M.A. Epidemiology and Ecology of Opportunistic Premise Plumbing Pathogens: Legionella pneumophila , Mycobacterium avium , and Pseudomonas aeruginosa . Environ. Health Perspect. 2015 , 123 , 749–758. [ Google Scholar ] [ CrossRef ]
• European Centre for Disease Prevention and Control. EU Protocol for Testing of M. chimaera Infections Potentially Associated with Heater-Cooler Units Environmental Microbiology Investigations ; Technical Document; European Centre for Disease Prevention and Control: Solna, Sweden, 2015. [ Google Scholar ]
• Ministero della Salute. Raccomandazioni per Il Controllo Dell’infezione da Mycobacterium chimaera in Italia ; Ministero della Salute: Roma, Italy, 2019.
• Bolcato, M.; Rodriguez, D.; Aprile, A. Risk Management in the New Frontier of Professional Liability for Nosocomial Infection: Review of the Literature on Mycobacterium chimaera . Int. J. Environ. Res. Public Health 2020 , 17 , 7328. [ Google Scholar ] [ CrossRef ]
• Achermann, Y.; Rössle, M.; Hoffmann, M.; Deggim, V.; Kuster, S.; Zimmermann, D.R.; Bloemberg, G.; Hombach, M.; Hasse, B. Prosthetic Valve Endocarditis and Bloodstream Infection Due to Mycobacterium chimaera . J. Clin. Microbiol. 2013 , 51 , 1769–1773. [ Google Scholar ] [ CrossRef ]
• Zabost, A.T.; Szturmowicz, M.; Brzezińska, S.A.; Klatt, M.D.; Augustynowicz-Kopeć, E.M. Mycobacterium chimaera as an Underestimated Cause of NTM Lung Diseases in Patients Hospitalized in Pulmonary Wards. Pol. J. Microbiol. 2021 , 70 , 315–320. [ Google Scholar ] [ CrossRef ]
• Truden, S.; Žolnir-Dovč, M.; Sodja, E.; Starčič Erjavec, M. Nationwide Analysis of Mycobacterium chimaera and Mycobacterium intracellulare Isolates: Frequency, Clinical Importance, and Molecular and Phenotypic Resistance Profiles. Infect. Genet. Evol. 2020 , 82 , 104311. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews. BMJ 2021 , 372 , 71. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Bills, N.D.; Hinrichs, S.H.; Aden, T.A.; Wickert, R.S.; Iwen, P.C. Molecular Identification of Mycobacterium chimaera as a Cause of Infection in a Patient with Chronic Obstructive Pulmonary Disease. Diagn. Microbiol. Infect. Dis. 2009 , 63 , 292–295. [ Google Scholar ] [ CrossRef ]
• Cohen-Bacrie, S.; David, M.; Stremler, N.; Dubus, J.-C.; Rolain, J.-M.; Drancourt, M. Mycobacterium chimaera Pulmonary Infection Complicating Cystic Fibrosis: A Case Report. J. Med. Case Rep. 2011 , 5 , 473. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Alhanna, J.; Purucker, M.; Steppert, C.; Grigull-Daborn, A.; Schiffel, G.; Gruber, H.; Borgmann, S. Mycobacterium chimaera Causes Tuberculosis-like Infection in a Male Patient with Anorexia Nervosa. Int. J. Eat. Disord. 2012 , 45 , 450–452. [ Google Scholar ] [ CrossRef ]
• Gunaydin, M.; Yanik, K.; Eroglu, C.; Sanic, A.; Ceyhan, I.; Erturan, Z.; Durmaz, R. Distribution of Nontuberculous Mycobacteria Strains. Ann. Clin. Microbiol. Antimicrob. 2013 , 12 , 33. [ Google Scholar ] [ CrossRef ]
• Boyle, D.P.; Zembower, T.R.; Reddy, S.; Qi, C. Comparison of Clinical Features, Virulence, and Relapse among Mycobacterium avium Complex Species. Am. J. Respir. Crit. Care Med. 2015 , 191 , 1310–1317. [ Google Scholar ] [ CrossRef ]
• Mwikuma, G.; Kwenda, G.; Hang’ombe, B.M.; Simulundu, E.; Kaile, T.; Nzala, S.; Siziya, S.; Suzuki, Y. Molecular Identification of Non-Tuberculous Mycobacteria Isolated from Clinical Specimens in Zambia. Ann. Clin. Microbiol. Antimicrob. 2015 , 14 , 1. [ Google Scholar ] [ CrossRef ]
• Moon, S.M.; Kim, S.Y.; Jhun, B.W.; Lee, H.; Park, H.Y.; Jeon, K.; Huh, H.J.; Ki, C.S.; Lee, N.Y.; Shin, S.J.; et al. Clinical Characteristics and Treatment Outcomes of Pulmonary Disease Caused by Mycobacterium chimaera . Diagn. Microbiol. Infect. Dis. 2016 , 86 , 382–384. [ Google Scholar ] [ CrossRef ]
• Moutsoglou, D.M.; Merritt, F.; Cumbler, E. Disseminated Mycobacterium chimaera Presenting as Vertebral Osteomyelitis. Case Rep. Infect. Dis. 2017 , 2017 , 9893743. [ Google Scholar ] [ CrossRef ]
• Bursle, E.; Playford, E.G.; Coulter, C.; Griffin, P. First Australian Case of Disseminated Mycobacterium chimaera Infection Post-Cardiothoracic Surgery. Infect. Dis. Health 2017 , 22 , 1–5. [ Google Scholar ] [ CrossRef ]
• Kim, S.-Y.; Shin, S.H.; Moon, S.M.; Yang, B.; Kim, H.; Kwon, O.J.; Huh, H.J.; Ki, C.-S.; Lee, N.Y.; Shin, S.J.; et al. Distribution and Clinical Significance of Mycobacterium avium Complex Species Isolated from Respiratory Specimens. Diagn. Microbiol. Infect. Dis. 2017 , 88 , 125–137. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Chand, M.; Lamagni, T.; Kranzer, K.; Hedge, J.; Moore, G.; Parks, S.; Collins, S.; Del Ojo Elias, C.; Ahmed, N.; Brown, T.; et al. Insidious Risk of Severe Mycobacterium chimaera Infection in Cardiac Surgery Patients. Clin. Infect. Dis. 2017 , 64 , 335–342. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Truden, S.; Žolnir-Dovč, M.; Sodja, E.; Starčič Erjavec, M. Retrospective Analysis of Slovenian Mycobacterium avium Complex and Mycobacterium abscessus Complex Isolates and Molecular Resistance Profile. Russ. J. Infect. Immun. 2018 , 8 , 447–451. [ Google Scholar ] [ CrossRef ]
• Larcher, R.; Lounnas, M.; Dumont, Y.; Michon, A.L.; Bonzon, L.; Chiron, R.; Carriere, C.; Klouche, K.; Godreuil, S. Mycobacterium chimaera Pulmonary Disease in Cystic Fibrosis Patients, France, 2010–2017. Emerg. Infect. Dis. 2019 , 25 , 611–613. [ Google Scholar ] [ CrossRef ]
• Shafizadeh, N.; Hale, G.; Bhatnagar, J.; Alshak, N.S.; Nomura, J. Mycobacterium chimaera Hepatitis: A New Disease Entity. Am. J. Surg. Pathol. 2019 , 43 , 244–250. [ Google Scholar ] [ CrossRef ]
• Rosero, C.I.; Shams, W.E. Mycobacterium chimaera Infection Masquerading as a Lung Mass in a Healthcare Worker. IDCases 2019 , 15 , e00526. [ Google Scholar ] [ CrossRef ]
• Watanabe, R.; Seino, H.; Taniuchi, S.; Igusa, R. Mycobacterium chimaera -Induced Tenosynovitis in a Patient with Rheumatoid Arthritis. BMJ Case Rep. 2020 , 13 , e233868. [ Google Scholar ] [ CrossRef ]
• Chen, L.C.; Huang, H.N.; Yu, C.J.; Chien, J.Y.; Hsueh, P.R. Clinical Features and Treatment Outcomes of Mycobacterium chimaera Lung Disease and Antimicrobial Susceptibility of the Mycobacterial Isolates. J. Infect. 2020 , 80 , 437–443. [ Google Scholar ] [ CrossRef ]
• Maalouly, C.; Devresse, A.; Martin, A.; Rodriguez-Villalobos, H.; Kanaan, N.; Belkhir, L. Coinfection of Mycobacterium malmoense and Mycobacterium chimaera in a Kidney Transplant Recipient: A Case Report and Review of the Literature. Transpl. Infect. Dis. 2020 , 22 , e13241. [ Google Scholar ] [ CrossRef ]
• de Melo Carvalho, R.; Nunes, A.L.; Sa, R.; Ramos, I.; Valente, C.; Saraiva da Cunha, J. Mycobacterium chimaera Disseminated Infection. J. Med. Cases 2020 , 11 , 35–36. [ Google Scholar ] [ CrossRef ]
• Sharma, K.; Sharma, M.; Modi, M.; Joshi, H.; Goyal, M.; Sharma, A.; Ray, P.; Rowlinson, M.C. Mycobacterium chimaera and Chronic Meningitis. QJM Int. J. Med. 2020 , 113 , 563–564. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Kim, M.J.; Kim, K.M.; Shin, J.I.; Ha, J.H.; Lee, D.H.; Choi, J.G.; Park, J.S.; Byun, J.H.; Yoo, J.W.; Eum, S.; et al. Identification of Nontuberculous Mycobacteria in Patients with Pulmonary Diseases in Gyeongnam, Korea, Using Multiplex PCR and Multigene Sequence-Based Analysis. Can. J. Infect. Dis. Med. Microbiol. 2021 , 2021 , 8844306. [ Google Scholar ] [ CrossRef ]
• Kavvalou, A.; Stehling, F.; Tschiedel, E.; Kehrmann, J.; Walkenfort, B.; Hasenberg, M.; Olivier, M.; Steindor, M. Biofilm Infection of a Central Venous Port-Catheter Caused by Mycobacterium avium Complex in an Immunocompetent Child with Cystic Fibrosis. BMC Infect. Dis. 2022 , 22 , 321. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Robinson, B.; Chaudhri, M.; Miskoff, J.A. A Case of Cavitary Mycobacterium chimaera . Cureus 2022 , 14 , e26984. [ Google Scholar ] [ CrossRef ]
• Ahmad, M.; Yousaf, A.; Khan, H.M.W.; Munir, A.; Chandran, A. Mycobacterium chimaera Lung Infection and Empyema in a Patient without Cardiopulmonary Bypass. Bayl. Univ. Med. Cent. Proc. 2022 , 35 , 817–819. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• George, M.; Afra, T.P.; Santhosh, P.; Nandakumar, G.; Balagopalan, D.; Sreedharan, S. Ulcerating Nodules on the Face Due to Mycobacterium chimaera in a Patient with Diabetes. Clin. Exp. Dermatol. 2022 , 47 , 587–589. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Lin, Y.F.; Lee, T.F.; Wu, U.I.; Huang, C.F.; Cheng, A.; Lin, K.Y.; Hung, C.C. Disseminated Mycobacterium chimaera Infection in a Patient with Adult-Onset Immunodeficiency Syndrome: Case Report. BMC Infect. Dis. 2022 , 22 , 665. [ Google Scholar ] [ CrossRef ]
• Łyżwa, E.; Siemion-Szcześniak, I.; Sobiecka, M.; Lewandowska, K.; Zimna, K.; Bartosiewicz, M.; Jakubowska, L.; Augustynowicz-Kopeć, E.; Tomkowski, W. An Unfavorable Outcome of M. Chimaera Infection in Patient with Silicosis. Diagnostics 2022 , 12 , 1826. [ Google Scholar ] [ CrossRef ]
• McLaughlin, C.M.; Schade, M.; Cochran, E.; Taylor, K.F. A Case Report of a Novel Atypical Mycobacterial Infection: Mycobacterium chimaera Hand Tenosynovitis. JBJS Case Connect. 2022 , 12 , e22. [ Google Scholar ] [ CrossRef ]
• Gross, J.E.; Teneback, C.C.; Sweet, J.G.; Caceres, S.M.; Poch, K.R.; Hasan, N.A.; Jia, F.; Epperson, L.E.; Lipner, E.M.; Vang, C.K.; et al. Molecular Epidemiologic Investigation of Mycobacterium intracellulare Subspecies Chimaera Lung Infections at an Adult Cystic Fibrosis Program. Ann. Am. Thorac. Soc. 2023 , 20 , 677–686. [ Google Scholar ] [ CrossRef ]
• Azzarà, C.; Lombardi, A.; Gramegna, A.; Ori, M.; Gori, A.; Blasi, F.; Bandera, A. Non-Tuberculous Mycobacteria Lung Disease Due to Mycobacterium chimaera in a 67-Year-Old Man Treated with Immune Checkpoint Inhibitors for Lung Adenocarcinoma: Infection Due to Dysregulated Immunity? BMC Infect. Dis. 2023 , 23 , 573. [ Google Scholar ] [ CrossRef ]
• Pradhan, A.; Martinez, E.; Sintchenko, V.; Post, J.; Overton, K. Case of Mycobacterium chimaera Vertebral Osteomyelitis Diagnosed 7 Years after Cardiac Surgery. Intern. Med. J. 2023 , 53 , 150–151. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Garcia-Prieto, F.; Rodríguez Perojo, A.; Río Ramírez, M.T. Endobronchial Fibroanthracosis Associated with Mycobacterium chimaera Infection: An Exceptional Case. Open Respir. Arch. 2024 , 6 , 100309. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Paul, S.; MacNair, A.; Lostarakos, V.; Capstick, R. Non-Tuberculous Mycobacterial Pulmonary Infection Presenting in a Patient with Unilateral Pulmonary Artery Agenesis. BMJ Case Rep. 2024 , 17 , e259125. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Bittner, M.J.; Preheim, L.C. Other Slow-Growing Nontuberculous Mycobacteria. Microbiol. Spectr. 2016 , 4 , 767–776. [ Google Scholar ] [ CrossRef ]
• Tortoli, E.; Rindi, L.; Garcia, M.J.; Chiaradonna, P.; Dei, R.; Garzelli, C.; Kroppenstedt, R.M.; Lari, N.; Mattei, R.; Mariottini, A.; et al. Proposal to Elevate the Genetic Variant MAC-A Included in the Mycobacterium avium Complex, to Species Rank as Mycobacterium chimaera sp. nov. Int. J. Syst. Evol. Microbiol. 2004 , 54 , 1277–1285. [ Google Scholar ] [ CrossRef ]
• Turankar, R.P.; Singh, V.; Gupta, H.; Pathak, V.K.; Ahuja, M.; Singh, I.; Lavania, M.; Dinda, A.K.; Sengupta, U. Association of Non-Tuberculous Mycobacteria with Mycobacterium leprae in Environment of Leprosy Endemic Regions in India. Infect. Genet. Evol. 2019 , 72 , 191–198. [ Google Scholar ] [ CrossRef ]
• Makovcova, J.; Slany, M.; Babak, V.; Slana, I.; Kralik, P. The Water Environment as a Source of Potentially Pathogenic Mycobacteria. J. Water Health 2014 , 12 , 254–263. [ Google Scholar ] [ CrossRef ]
• Falkinham, J.O. Ecology of Nontuberculous Mycobacteria-Where Do Human Infections Come From? Semin. Respir. Crit. Care Med. 2013 , 34 , 95–102. [ Google Scholar ] [ CrossRef ]
• Norton, G.J.; Williams, M.; Falkinham, J.O., III; Honda, J.R. Physical Measures to Reduce Exposure to Tap Water-Associated Nontuberculous Mycobacteria. Front. Public Health 2020 , 8 , 190. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Durnez, L.; Eddyani, M.; Mgode, G.F.; Katakweba, A.; Katholi, C.R.; Machang’u, R.R.; Kazwala, R.R.; Portaels, F.; Leirs, H. First Detection of Mycobacteria in African Rodents and Insectivores, Using Stratified Pool Screening. Appl. Environ. Microbiol. 2008 , 74 , 768. [ Google Scholar ] [ CrossRef ]
• Sax, H.; Bloemberg, G.; Hasse, B.; Sommerstein, R.; Kohler, P.; Achermann, Y.; Rössle, M.; Falk, V.; Kuster, S.P.; Böttger, E.C.; et al. Prolonged Outbreak of Mycobacterium chimaera Infection after Open-Chest Heart Surgery. Clin. Infect. Dis. 2015 , 61 , 67–75. [ Google Scholar ] [ CrossRef ]
• Falkinham, J.O.; Williams, M.D. Desiccation-Tolerance of Mycobacterium avium , Mycobacterium intracellulare , Mycobacterium chimaera , Mycobacterium abscessus and Mycobacterium chelonae . Pathogens 2022 , 11 , 463. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Gebert, M.J.; Delgado-Baquerizo, M.; Oliverio, A.M.; Webster, T.M.; Nichols, L.M.; Honda, J.R.; Chan, E.D.; Adjemian, J.; Dunn, R.R.; Fierer, N. Ecological Analyses of Mycobacteria in Showerhead Biofilms and Their Relevance to Human Health. mBio 2018 , 9 , e01614–e01618. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Cao, Y.; Yuan, S.; Pang, L.; Xie, J.; Gao, Y.; Zhang, J.; Zhao, Z.; Yao, S. Study on Microbial Diversity of Washing Machines. Biodegradation 2024 , 1–13. [ Google Scholar ] [ CrossRef ]
• Liu, H.; Jiao, P.; Guan, L.; Wang, C.; Zhang, X.X.; Ma, L. Functional Traits and Health Implications of the Global Household Drinking-Water Microbiome Retrieved Using an Integrative Genome-Centric Approach. Water Res. 2024 , 250 , 121094. [ Google Scholar ] [ CrossRef ]
• Choi, J.Y.; Sim, B.R.; Park, Y.; Yong, S.H.; Shin, S.J.; Kang, Y.A. Identification of Nontuberculous Mycobacteria Isolated from Household Showerheads of Patients with Nontuberculous Mycobacteria. Sci. Rep. 2022 , 12 , 8648. [ Google Scholar ] [ CrossRef ]
• Shen, Y.; Haig, S.J.; Prussin, A.J.; Lipuma, J.J.; Marr, L.C.; Raskin, L. Shower Water Contributes Viable Nontuberculous Mycobacteria to Indoor Air. PNAS Nexus 2022 , 1 , pgac145. [ Google Scholar ] [ CrossRef ]
• Struelens, M.J.; Plachouras, D. Mycobacterium chimaera Infections Associated with Heater-Cooler Units (HCU): Closing Another Loophole in Patient Safety. Eurosurveillance 2016 , 21 , 30397. [ Google Scholar ] [ CrossRef ]
• Trudzinski, F.C.; Schlotthauer, U.; Kamp, A.; Hennemann, K.; Muellenbach, R.M.; Reischl, U.; Gärtner, B.; Wilkens, H.; Bals, R.; Herrmann, M.; et al. Clinical Implications of Mycobacterium chimaera Detection in Thermoregulatory Devices Used for Extracorporeal Membrane Oxygenation (ECMO), Germany, 2015 to 2016. Eurosurveillance 2016 , 21 , 30398. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Schnetzinger, M.; Heger, F.; Indra, A.; Kimberger, O. Bacterial Contamination of Water Used as Thermal Transfer Fluid in Fluid-Warming Devices. J. Hosp. Infect. 2023 , 141 , 49–54. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Barker, T.A.; Dandekar, U.; Fraser, N.; Dawkin, L.; Sweeney, P.; Heron, F.; Simmons, J.; Parmar, J. Minimising the Risk of Mycobacterium chimaera Infection during Cardiopulmonary Bypass by the Removal of Heater-Cooler Units from the Operating Room. Perfusion 2018 , 33 , 264–269. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Barnes, S.; Twomey, C.; Carrico, R.; Murphy, C.; Warye, K. OR Air Quality: Is It Time to Consider Adjunctive Air Cleaning Technology? AORN J. 2018 , 108 , 503–515. [ Google Scholar ] [ CrossRef ]
• Walker, J.T.; Lamagni, T.; Chand, M. Evidence That Mycobacterium chimaera Aerosols Penetrate Laminar Airflow and Result in Infections at the Surgical Field. Lancet Infect. Dis. 2017 , 17 , 1019. [ Google Scholar ] [ CrossRef ]
• Schlotthauer, U.; Hennemann, K.; Gärtner, B.C.; Schäfers, H.-J.; Becker, S.L. Microbiological Surveillance of Heater-Cooler Units Used in Cardiothoracic Surgery for Detection of Mycobacterium chimaera . Thorac. Cardiovasc. Surg. 2022 , 72 , 59–62. [ Google Scholar ] [ CrossRef ]
• Gross, J.E.; Caceres, S.; Poch, K.; Epperson, L.E.; Hasan, N.A.; Jia, F.; de Moura, V.C.N.; Strand, M.; Lipner, E.M.; Honda, J.R.; et al. Prospective Healthcare-Associated Links in Transmission of Nontuberculous Mycobacteria among People with Cystic Fibrosis (PHALT NTM) Study: Rationale and Study Design. PLoS ONE 2023 , 18 , e0291910. [ Google Scholar ] [ CrossRef ]
• Nakamura, S.; Azuma, M.; Sato, M.; Fujiwara, N.; Nishino, S.; Wada, T.; Yoshida, S. Pseudo-Outbreak of Mycobacterium chimaera through Aerators of Hand-Washing Machines at a Hematopoietic Stem Cell Transplantation Center. Infect. Control Hosp. Epidemiol. 2019 , 40 , 1433–1435. [ Google Scholar ] [ CrossRef ]
• Kanamori, H.; Weber, D.J.; Rutala, W.A. Healthcare-Associated Mycobacterium chimaera Transmission and Infection Prevention Challenges: Role of Heater-Cooler Units as a Water Source in Cardiac Surgery. Clin. Infect. Dis. 2017 , 64 , 343–346. [ Google Scholar ] [ CrossRef ]
• Rao, M.; Silveira, F.P. Non-Tuberculous Mycobacterial Infections in Thoracic Transplant Candidates and Recipients. Curr. Infect. Dis. Rep. 2018 , 20 , 14. [ Google Scholar ] [ CrossRef ]
• Walker, J.; Moore, G.; Collins, S.; Parks, S.; Garvey, M.I.; Lamagni, T.; Smith, G.; Dawkin, L.; Goldenberg, S.; Chand, M. Microbiological Problems and Biofilms Associated with Mycobacterium chimaera in Heater–Cooler Units Used for Cardiopulmonary Bypass. J. Hosp. Infect. 2017 , 96 , 209–220. [ Google Scholar ] [ CrossRef ]
• Born, F.; Wieser, A.; Oberbach, A.; Oberbach, A.; Ellgass, R.; Peterss, S.; Kur, F.; Grabein, B.; Hagl, C. Five Years without Mycobacterium chimaera . Thorac. Cardiovasc. Surg. 2020 , 68 , S1–S72. [ Google Scholar ] [ CrossRef ]
• Scriven, J.E.; Scobie, A.; Verlander, N.Q.; Houston, A.; Collyns, T.; Cajic, V.; Kon, O.M.; Mitchell, T.; Rahama, O.; Robinson, A.; et al. Mycobacterium chimaera Infection Following Cardiac Surgery in the United Kingdom: Clinical Features and Outcome of the First 30 Cases. Clin. Microbiol. Infect. 2018 , 24 , 1164–1170. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Olatidoye, O.A.; Samat, S.H.; Yin, K.; Bates, M.J. Pulmonary Valve Infective Endocarditis Caused by Mycobacterium abscessus . J. Cardiothorac. Surg. 2023 , 18 , 221. [ Google Scholar ] [ CrossRef ]
• Ganatra, S.; Sharma, A.; D’Agostino, R.; Gage, T.; Kinnunen, P. Mycobacterium chimaera Mimicking Sarcoidosis. Methodist Debakey Cardiovasc. J. 2018 , 14 , 301–302. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Buchanan, R.; Agarwal, A.; Mathai, E.; Cherian, B. Mycobacterium chimaera : A Novel Pathogen with Potential Risk to Cardiac Surgical Patients. Natl. Med. J. India 2020 , 33 , 284–287. [ Google Scholar ] [ CrossRef ]
• McHugh, J.; Saleh, O.A. Updates in Culture-Negative Endocarditis. Pathogens 2023 , 12 , 1027. [ Google Scholar ] [ CrossRef ]
• Delgado, V.; Ajmone Marsan, N.; De Waha, S.; Bonaros, N.; Brida, M.; Burri, H.; Caselli, S.; Doenst, T.; Ederhy, S.; Erba, P.A.; et al. 2023 ESC Guidelines for the Management of Endocarditis. Eur. Heart J. 2023 , 44 , 3948–4042. [ Google Scholar ] [ CrossRef ]
• Kohler, P.; Kuster, S.P.; Bloemberg, G.; Schulthess, B.; Frank, M.; Tanner, F.C.; Rössle, M.; Böni, C.; Falk, V.; Wilhelm, M.J.; et al. Healthcare-Associated Prosthetic Heart Valve, Aortic Vascular Graft, and Disseminated Mycobacterium chimaera Infections Subsequent to Open Heart Surgery. Eur. Heart J. 2015 , 36 , 2745–2753. [ Google Scholar ] [ CrossRef ]
• Wyrostkiewicz, D.; Opoka, L.; Filipczak, D.; Jankowska, E.; Skorupa, W.; Augustynowicz-Kopeć, E.; Szturmowicz, M. Nontuberculous Mycobacterial Lung Disease in the Patients with Cystic Fibrosis—A Challenging Diagnostic Problem. Diagnostics 2022 , 12 , 1514. [ Google Scholar ] [ CrossRef ]
• Virdi, R.; Lowe, M.E.; Norton, G.J.; Dawrs, S.N.; Hasan, N.A.; Epperson, L.E.; Glickman, C.M.; Chan, E.D.; Strong, M.; Crooks, J.L.; et al. Lower Recovery of Nontuberculous Mycobacteria from Outdoor Hawai’i Environmental Water Biofilms Compared to Indoor Samples. Microorganisms 2021 , 9 , 224. [ Google Scholar ] [ CrossRef ]
• Schweickert, B.; Goldenberg, O.; Richter, E.; Göbel, U.B.; Petrich, A.; Buchholz, P.; Moter, A. Occurrence and Clinical Relevance of Mycobacterium chimaera sp. nov., Germany. Emerg. Infect. Dis. 2008 , 14 , 1443–1446. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Boyle, D.P.; Zembower, T.R.; Qi, C. Evaluation of Vitek MS for Rapid Classification of Clinical Isolates Belonging to Mycobacterium avium Complex. Diagn. Microbiol. Infect. Dis. 2015 , 81 , 41–43. [ Google Scholar ] [ CrossRef ]
• Sommerstein, R.; Rüegg, C.; Kohler, P.; Bloemberg, G.; Kuster, S.P.; Sax, H. Transmission of Mycobacterium chimaera from Heater-Cooler Units during Cardiac Surgery despite an Ultraclean Air Ventilation System. Emerg. Infect. Dis. 2016 , 22 , 1008–1013. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Balsam, L.B.; Louie, E.; Hill, F.; Levine, J.; Phillips, M.S. Mycobacterium chimaera Left Ventricular Assist Device Infections. J. Card. Surg. 2017 , 32 , 402–404. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Sanchez-Nadales, A.; Diaz-Sierra, A.; Mocadie, M.; Asher, C.; Gordon, S.; Xu, B. Advanced Cardiovascular Imaging for the Diagnosis of Mycobacterium chimaera Prosthetic Valve Infective Endocarditis After Open-Heart Surgery: A Contemporary Systematic Review. Curr. Probl. Cardiol. 2022 , 47 , 101392. [ Google Scholar ] [ CrossRef ]
• Cannas, A.; Campanale, A.; Minella, D.; Messina, F.; Butera, O.; Nisii, C.; Mazzarelli, A.; Fontana, C.; Lispi, L.; Maraglino, F.; et al. Epidemiological and Molecular Investigation of the Heater–Cooler Unit (HCU)-Related Outbreak of Invasive Mycobacterium chimaera Infection Occurred in Italy. Microorganisms 2023 , 11 , 2251. [ Google Scholar ] [ CrossRef ]
• Schreiber, P.W.; Kohl, T.A.; Kuster, S.P.; Niemann, S.; Sax, H. The Global Outbreak of Mycobacterium chimaera Infections in Cardiac Surgery—A Systematic Review of Whole-Genome Sequencing Studies and Joint Analysis. Clin. Microbiol. Infect. 2021 , 27 , 1613–1620. [ Google Scholar ] [ CrossRef ]
• Rubinstein, M.; Grossman, R.; Nissan, I.; Schwaber, M.J.; Carmeli, Y.; Kaidar-Shwartz, H.; Dveyrin, Z.; Rorman, E. Mycobacterium intracellulare Subsp. Chimaera from Cardio Surgery Heating-Cooling Units and from Clinical Samples in Israel Are Genetically Unrelated. Pathogens 2021 , 10 , 1392. [ Google Scholar ] [ CrossRef ]
• Mercaldo, R.A.; Marshall, J.E.; Prevots, D.R.; Lipner, E.M.; French, J.P. Detecting Clusters of High Nontuberculous Mycobacteria Infection Risk for Persons with Cystic Fibrosis—An Analysis of U.S. Counties. Tuberculosis 2023 , 138 , 102296. [ Google Scholar ] [ CrossRef ]
• Asadi, T.; Mullin, K.; Roselli, E.; Johnston, D.; Tan, C.D.; Rodriguez, E.R.; Gordon, S. Disseminated Mycobacterium chimaera Infection Associated with Heater-Cooler Units after Aortic Valve Surgery without Endocarditis. J. Thorac. Cardiovasc. Surg. 2018 , 155 , 2369–2374. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Clemente, T.; Spagnuolo, V.; Bottanelli, M.; Ripa, M.; Del Forno, B.; Busnardo, E.; Di Lucca, G.; Castagna, A.; Danise, A. Disseminated Mycobacterium chimaera Infection Favoring the Development of Kaposi’s Sarcoma: A Case Report. Ann. Clin. Microbiol. Antimicrob. 2022 , 21 , 57. [ Google Scholar ] [ CrossRef ]
• Schaeffer, T.; Kuster, S.; Koechlin, L.; Khanna, N.; Eckstein, F.S.; Reuthebuch, O. Long-Term Follow-Up after Mycobacterium chimaera Infection Following Cardiac Surgery: Single-Center Experience. J. Clin. Med. 2023 , 12 , 948. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Trauth, J.; Matt, U.; Kohl, T.A.; Niemann, S.; Herold, S. Blind Spot in Endocarditis Guidelines: Mycobacterium chimaera Prosthetic Valve Endocarditis after Cardiac Surgery—A Case Series. Eur. Heart J. Case Rep. 2023 , 7 , ytad400. [ Google Scholar ] [ CrossRef ]
• Sanavio, M.; Anna, A.; Bolcato, M. Mycobacterium chimaera : Clinical and Medico-Legal Considerations Starting from a Case of Sudden Acoustic Damage. Leg. Med. 2020 , 47 , 101747. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• van Ingen, J. Microbiological Diagnosis of Nontuberculous Mycobacterial Pulmonary Disease. Clin. Chest Med. 2015 , 36 , 43–54. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Wang, H.; Bédard, E.; Prévost, M.; Camper, A.K.; Hill, V.R.; Pruden, A. Methodological Approaches for Monitoring Opportunistic Pathogens in Premise Plumbing: A Review. Water Res. 2017 , 117 , 68–86. [ Google Scholar ] [ CrossRef ]
• Hasse, B.; Hannan, M.M.; Keller, P.M.; Maurer, F.P.; Sommerstein, R.; Mertz, D.; Wagner, D.; Fernández-Hidalgo, N.; Nomura, J.; Manfrin, V.; et al. International Society of Cardiovascular Infectious Diseases Guidelines for the Diagnosis, Treatment and Prevention of Disseminated Mycobacterium chimaera Infection Following Cardiac Surgery with Cardiopulmonary Bypass. J. Hosp. Infect. 2020 , 104 , 214–235. [ Google Scholar ] [ CrossRef ]
• Schreiber, P.W.; Köhler, N.; Cervera, R.; Hasse, B.; Sax, H.; Keller, P.M. Detection Limit of Mycobacterium chimaera in Water Samples for Monitoring Medical Device Safety: Insights from a Pilot Experimental Series. J. Hosp. Infect. 2018 , 99 , 284–289. [ Google Scholar ] [ CrossRef ]
• Daley, C.L.; Iaccarino, J.M.; Lange, C.; Cambau, E.; Wallace, R.J.; Andrejak, C.; Böttger, E.C.; Brozek, J.; Griffith, D.E.; Guglielmetti, L.; et al. Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline. Clin. Infect. Dis. 2020 , 71 , e1–e36. [ Google Scholar ] [ CrossRef ]
• Lecorche, E.; Haenn, S.; Mougari, F.; Kumanski, S.; Veziris, N.; Benmansour, H.; Raskine, L.; Moulin, L.; Cambau, E.; Aubry, A.; et al. Comparison of Methods Available for Identification of Mycobacterium chimaera . Clin. Microbiol. Infect. 2018 , 24 , 409–413. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Lyamin, A.V.; Ereshchenko, A.A.; Gusyakova, O.A.; Yanchenko, A.V.; Kozlov, A.V.; Khaliulin, A.V. Comparison of Laboratory Methods for Identifying Members of the Family Mycobacteriaceae. Int. J. Mycobacteriol 2023 , 12 , 129–134. [ Google Scholar ] [ CrossRef ]
• Togawa, A.; Chikamatsu, K.; Takaki, A.; Matsumoto, Y.; Yoshimura, M.; Tsuchiya, S.; Nakamura, S.; Mitarai, S. Multiple Mutations of Mycobacterium ntracellulare Subsp. Chimaera Causing False-Negative Reaction to the Transcription-Reverse Transcription Concerted Method for Pathogen Detection. Int. J. Infect. Dis. 2023 , 133 , 14–17. [ Google Scholar ] [ CrossRef ]
• Kuehl, R.; Banderet, F.; Egli, A.; Keller, P.M.; Frei, R.; Döbele, T.; Eckstein, F.; Widmer, A.F. Different Types of Heater-Cooler Units and Their Risk of Transmission of Mycobacterium chimaera during Open-Heart Surgery: Clues from Device Design. Infect. Control Hosp. Epidemiol. 2018 , 39 , 834–840. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Quintás Viqueira, A.; Pérez Romero, C.; Toro Rueda, C.; Sánchez Calles, A.M.; Blázquez González, J.A.; Alejandre Leyva, M. Mycobacterium chimaera in Heater-Cooler Devices: An Experience in a Tertiary Hospital in Spain. New Microbes New Infect. 2021 , 39 , 100757. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Falkinham, J.O., III. Disinfection and Cleaning of Heater-Cooler Units: Suspension- and Biofilm-Killing. J. Hosp. Infect. 2020 , 105 , 552–557. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Hammer-Dedet, F.; Dupont, C.; Evrevin, M.; Jumas-Bilak, E.; Romano-Bertrand, S. Improved Detection of Non-Tuberculous Mycobacteria in Hospital Water Samples. Infect. Dis. Now 2021 , 51 , 488–491. [ Google Scholar ] [ CrossRef ]
• Romano-Bertrand, S.; Evrevin, M.; Dupont, C.; Frapier, J.M.; Sinquet, J.C.; Bousquet, E.; Albat, B.; Jumas-Bilak, E. Persistent Contamination of Heater-Cooler Units for Extracorporeal Circulation Cured by Chlorhexidine-Alcohol in Water Tanks. J. Hosp. Infect. 2018 , 99 , 290–294. [ Google Scholar ] [ CrossRef ]
• Colangelo, N.; Giambuzzi, I.; Moro, M.; Pasqualini, N.; Aina, A.; De Simone, F.; Blasio, A.; Alfieri, O.; Castiglioni, A.; De Bonis, M. Mycobacterium chimaera in Heater–Cooler Units: New Technical Approach for Treatment, Cleaning and Disinfection Protocol. Perfusion 2019 , 34 , 272–276. [ Google Scholar ] [ CrossRef ]
• Ditommaso, S.; Giacomuzzi, M.; Memoli, G.; Garlasco, J.; Curtoni, A.; Iannaccone, M.; Zotti, C.M. Chemical Susceptibility Testing of Non-Tuberculous Mycobacterium strains and Other Aquatic Bacteria: Results of a Study for the Development of a More Sensitive and Simple Method for the Detection of NTM in Environmental Samples. J. Microbiol. Methods 2022 , 193 , 106405. [ Google Scholar ] [ CrossRef ]
• Shrimpton, N.Y.R. Evaluation of Disinfection Processes for Water Heater Devices Used for Extracorporeal Life Support. Perfusion 2019 , 34 , 428–432. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Sarink, M.J.; van Cappellen, W.A.; Tielens, A.G.M.; van Dijk, A.; Bogers, A.J.J.C.; de Steenwinkel, J.E.M.; Vos, M.C.; Severin, J.A.; van Hellemond, J.J. Vermamoeba Vermiformis Resides in Water-Based Heater–Cooler Units and Can Enhance Mycobacterium chimaera Survival after Chlorine Exposure. J. Hosp. Infect. 2023 , 132 , 73–77. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Bengtsson, D.; Westerberg, M.; Nielsen, S.; Ridell, M.; Jönsson, B. Mycobacterium chimaera in Heater-Cooler Units Used during Cardiac Surgery–Growth and Decontamination. Infect. Dis. 2018 , 50 , 736–742. [ Google Scholar ] [ CrossRef ] [ PubMed ]
• Weitkemper, H.H.; Spilker, A.; Knobl, H.J.; Körfer, R. The Heater-Cooler Unit-A Conceivable Source of Infection. J. Extra Corpor. Technol. 2016 , 48 , 62–66. [ Google Scholar ] [ CrossRef ]
• Foltan, M.; Nikisch, A.; Dembianny, J.; Miano, A.L.; Heinze, J.; Klar, D.; Göbölös, L.; Lehle, K.; Schmid, C. A Solution for Global Hygienic Challenges Regarding the Application of Heater-Cooler Systems in Cardiac Surgery. Perfusion 2023 , 38 , 28–36. [ Google Scholar ] [ CrossRef ]
• Pradal, I.; Esteban, J.; Mediero, A.; García-Coca, M.; Aguilera-Correa, J.J. Contact Effect of a Methylobacterium sp. Extract on Biofilm of a Mycobacterium chimaera Strain Isolated from a 3T Heater-Cooler System. Antibiotics 2020 , 9 , 474. [ Google Scholar ] [ CrossRef ]
• Masaka, E.; Reed, S.; Davidson, M.; Oosthuizen, J. Opportunistic Premise Plumbing Pathogens. A Potential Health Risk in Water Mist Systems Used as a Cooling Intervention. Pathogens 2021 , 10 , 462. [ Google Scholar ] [ CrossRef ]
• Treglia, M.; Pallocci, M.; Ricciardi Tenore, G.; Castellani, P.; Pizzuti, F.; Bianco, G.; Passalacqua, P.; De Luca, L.; Zanovello, C.; Mazzuca, D.; et al. Legionella and Air Transport: A Study of Environmental Contamination. Int. J. Environ. Res. Public Health 2022 , 19 , 8069. [ Google Scholar ] [ CrossRef ]
• Glassmeyer, S.T.; Burns, E.E.; Focazio, M.J.; Furlong, E.T.; Gribble, M.O.; Jahne, M.A.; Keely, S.P.; Kennicutt, A.R.; Kolpin, D.W.; Medlock Kakaley, E.K.; et al. Water, Water Everywhere, but Every Drop Unique: Challenges in the Science to Understand the Role of Contaminants of Emerging Concern in the Management of Drinking Water Supplies. Geohealth 2023 , 7 , e2022GH000716. [ Google Scholar ] [ CrossRef ]
• Ortiz-Martínez, Y. Mycobacterium chimaera : An under-Diagnosed Pathogen in Developing Countries? J. Hosp. Infect. 2017 , 97 , 125–126. [ Google Scholar ] [ CrossRef ]
• Becker, J.B.; Moisés, V.A.; Guerra-Martín, M.D.; Barbosa, D.A. Epidemiological Differences, Clinical Aspects, and Short-Term Prognosis of Patients with Healthcare-Associated and Community-Acquired Infective Endocarditis. Infect. Prev. Pract. 2024 , 6 , 100343. [ Google Scholar ] [ CrossRef ]
• Ferrara, S.D.; Baccino, E.; Bajanowski, T.; Boscolo-Berto, R.; Castellano, M.; De Angel, R.; Pauliukevičius, A.; Ricci, P.; Vanezis, P.; Vieira, D.N.; et al. Malpractice and Medical Liability. European Guidelines on Methods of Ascertainment and Criteria of Evaluation. Int. J. Leg. Med. 2013 , 127 , 545–557. [ Google Scholar ] [ CrossRef ]

Click here to enlarge figure

Share and Cite

Bolcato, V.; Bassetti, M.; Basile, G.; Bianco Prevot, L.; Speziale, G.; Tremoli, E.; Maffessanti, F.; Tronconi, L.P. The State-of-the-Art of Mycobacterium chimaera Infections and the Causal Link with Health Settings: A Systematic Review. Healthcare 2024 , 12 , 1788. https://doi.org/10.3390/healthcare12171788

Bolcato V, Bassetti M, Basile G, Bianco Prevot L, Speziale G, Tremoli E, Maffessanti F, Tronconi LP. The State-of-the-Art of Mycobacterium chimaera Infections and the Causal Link with Health Settings: A Systematic Review. Healthcare . 2024; 12(17):1788. https://doi.org/10.3390/healthcare12171788

Bolcato, Vittorio, Matteo Bassetti, Giuseppe Basile, Luca Bianco Prevot, Giuseppe Speziale, Elena Tremoli, Francesco Maffessanti, and Livio Pietro Tronconi. 2024. "The State-of-the-Art of Mycobacterium chimaera Infections and the Causal Link with Health Settings: A Systematic Review" Healthcare 12, no. 17: 1788. https://doi.org/10.3390/healthcare12171788

Article Metrics

Article access statistics, supplementary material.

ZIP-Document (ZIP, 83 KiB)

Further Information

Mdpi initiatives, follow mdpi.

Subscribe to receive issue release notifications and newsletters from MDPI journals