How to write a case study — examples, templates, and tools
It’s a marketer’s job to communicate the effectiveness of a product or service to potential and current customers to convince them to buy and keep business moving. One of the best methods for doing this is to share success stories that are relatable to prospects and customers based on their pain points, experiences, and overall needs.
That’s where case studies come in. Case studies are an essential part of a content marketing plan. These in-depth stories of customer experiences are some of the most effective at demonstrating the value of a product or service. Yet many marketers don’t use them, whether because of their regimented formats or the process of customer involvement and approval.
A case study is a powerful tool for showcasing your hard work and the success your customer achieved. But writing a great case study can be difficult if you’ve never done it before or if it’s been a while. This guide will show you how to write an effective case study and provide real-world examples and templates that will keep readers engaged and support your business.
In this article, you’ll learn:
What is a case study?
How to write a case study, case study templates, case study examples, case study tools.
A case study is the detailed story of a customer’s experience with a product or service that demonstrates their success and often includes measurable outcomes. Case studies are used in a range of fields and for various reasons, from business to academic research. They’re especially impactful in marketing as brands work to convince and convert consumers with relatable, real-world stories of actual customer experiences.
The best case studies tell the story of a customer’s success, including the steps they took, the results they achieved, and the support they received from a brand along the way. To write a great case study, you need to:
- Celebrate the customer and make them — not a product or service — the star of the story.
- Craft the story with specific audiences or target segments in mind so that the story of one customer will be viewed as relatable and actionable for another customer.
- Write copy that is easy to read and engaging so that readers will gain the insights and messages intended.
- Follow a standardized format that includes all of the essentials a potential customer would find interesting and useful.
- Support all of the claims for success made in the story with data in the forms of hard numbers and customer statements.
Case studies are a type of review but more in depth, aiming to show — rather than just tell — the positive experiences that customers have with a brand. Notably, 89% of consumers read reviews before deciding to buy, and 79% view case study content as part of their purchasing process. When it comes to B2B sales, 52% of buyers rank case studies as an important part of their evaluation process.
Telling a brand story through the experience of a tried-and-true customer matters. The story is relatable to potential new customers as they imagine themselves in the shoes of the company or individual featured in the case study. Showcasing previous customers can help new ones see themselves engaging with your brand in the ways that are most meaningful to them.
Besides sharing the perspective of another customer, case studies stand out from other content marketing forms because they are based on evidence. Whether pulling from client testimonials or data-driven results, case studies tend to have more impact on new business because the story contains information that is both objective (data) and subjective (customer experience) — and the brand doesn’t sound too self-promotional.
Case studies are unique in that there’s a fairly standardized format for telling a customer’s story. But that doesn’t mean there isn’t room for creativity. It’s all about making sure that teams are clear on the goals for the case study — along with strategies for supporting content and channels — and understanding how the story fits within the framework of the company’s overall marketing goals.
Here are the basic steps to writing a good case study.
1. Identify your goal
Start by defining exactly who your case study will be designed to help. Case studies are about specific instances where a company works with a customer to achieve a goal. Identify which customers are likely to have these goals, as well as other needs the story should cover to appeal to them.
The answer is often found in one of the buyer personas that have been constructed as part of your larger marketing strategy. This can include anything from new leads generated by the marketing team to long-term customers that are being pressed for cross-sell opportunities. In all of these cases, demonstrating value through a relatable customer success story can be part of the solution to conversion.
2. Choose your client or subject
Who you highlight matters. Case studies tie brands together that might otherwise not cross paths. A writer will want to ensure that the highlighted customer aligns with their own company’s brand identity and offerings. Look for a customer with positive name recognition who has had great success with a product or service and is willing to be an advocate.
The client should also match up with the identified target audience. Whichever company or individual is selected should be a reflection of other potential customers who can see themselves in similar circumstances, having the same problems and possible solutions.
Some of the most compelling case studies feature customers who:
- Switch from one product or service to another while naming competitors that missed the mark.
- Experience measurable results that are relatable to others in a specific industry.
- Represent well-known brands and recognizable names that are likely to compel action.
- Advocate for a product or service as a champion and are well-versed in its advantages.
Whoever or whatever customer is selected, marketers must ensure they have the permission of the company involved before getting started. Some brands have strict review and approval procedures for any official marketing or promotional materials that include their name. Acquiring those approvals in advance will prevent any miscommunication or wasted effort if there is an issue with their legal or compliance teams.
3. Conduct research and compile data
Substantiating the claims made in a case study — either by the marketing team or customers themselves — adds validity to the story. To do this, include data and feedback from the client that defines what success looks like. This can be anything from demonstrating return on investment (ROI) to a specific metric the customer was striving to improve. Case studies should prove how an outcome was achieved and show tangible results that indicate to the customer that your solution is the right one.
This step could also include customer interviews. Make sure that the people being interviewed are key stakeholders in the purchase decision or deployment and use of the product or service that is being highlighted. Content writers should work off a set list of questions prepared in advance. It can be helpful to share these with the interviewees beforehand so they have time to consider and craft their responses. One of the best interview tactics to keep in mind is to ask questions where yes and no are not natural answers. This way, your subject will provide more open-ended responses that produce more meaningful content.
4. Choose the right format
There are a number of different ways to format a case study. Depending on what you hope to achieve, one style will be better than another. However, there are some common elements to include, such as:
- An engaging headline
- A subject and customer introduction
- The unique challenge or challenges the customer faced
- The solution the customer used to solve the problem
- The results achieved
- Data and statistics to back up claims of success
- A strong call to action (CTA) to engage with the vendor
It’s also important to note that while case studies are traditionally written as stories, they don’t have to be in a written format. Some companies choose to get more creative with their case studies and produce multimedia content, depending on their audience and objectives. Case study formats can include traditional print stories, interactive web or social content, data-heavy infographics, professionally shot videos, podcasts, and more.
5. Write your case study
We’ll go into more detail later about how exactly to write a case study, including templates and examples. Generally speaking, though, there are a few things to keep in mind when writing your case study.
- Be clear and concise. Readers want to get to the point of the story quickly and easily, and they’ll be looking to see themselves reflected in the story right from the start.
- Provide a big picture. Always make sure to explain who the client is, their goals, and how they achieved success in a short introduction to engage the reader.
- Construct a clear narrative. Stick to the story from the perspective of the customer and what they needed to solve instead of just listing product features or benefits.
- Leverage graphics. Incorporating infographics, charts, and sidebars can be a more engaging and eye-catching way to share key statistics and data in readable ways.
- Offer the right amount of detail. Most case studies are one or two pages with clear sections that a reader can skim to find the information most important to them.
- Include data to support claims. Show real results — both facts and figures and customer quotes — to demonstrate credibility and prove the solution works.
6. Promote your story
Marketers have a number of options for distribution of a freshly minted case study. Many brands choose to publish case studies on their website and post them on social media. This can help support SEO and organic content strategies while also boosting company credibility and trust as visitors see that other businesses have used the product or service.
Marketers are always looking for quality content they can use for lead generation. Consider offering a case study as gated content behind a form on a landing page or as an offer in an email message. One great way to do this is to summarize the content and tease the full story available for download after the user takes an action.
Sales teams can also leverage case studies, so be sure they are aware that the assets exist once they’re published. Especially when it comes to larger B2B sales, companies often ask for examples of similar customer challenges that have been solved.
Now that you’ve learned a bit about case studies and what they should include, you may be wondering how to start creating great customer story content. Here are a couple of templates you can use to structure your case study.
Template 1 — Challenge-solution-result format
- Start with an engaging title. This should be fewer than 70 characters long for SEO best practices. One of the best ways to approach the title is to include the customer’s name and a hint at the challenge they overcame in the end.
- Create an introduction. Lead with an explanation as to who the customer is, the need they had, and the opportunity they found with a specific product or solution. Writers can also suggest the success the customer experienced with the solution they chose.
- Present the challenge. This should be several paragraphs long and explain the problem the customer faced and the issues they were trying to solve. Details should tie into the company’s products and services naturally. This section needs to be the most relatable to the reader so they can picture themselves in a similar situation.
- Share the solution. Explain which product or service offered was the ideal fit for the customer and why. Feel free to delve into their experience setting up, purchasing, and onboarding the solution.
- Explain the results. Demonstrate the impact of the solution they chose by backing up their positive experience with data. Fill in with customer quotes and tangible, measurable results that show the effect of their choice.
- Ask for action. Include a CTA at the end of the case study that invites readers to reach out for more information, try a demo, or learn more — to nurture them further in the marketing pipeline. What you ask of the reader should tie directly into the goals that were established for the case study in the first place.
Template 2 — Data-driven format
- Start with an engaging title. Be sure to include a statistic or data point in the first 70 characters. Again, it’s best to include the customer’s name as part of the title.
- Create an overview. Share the customer’s background and a short version of the challenge they faced. Present the reason a particular product or service was chosen, and feel free to include quotes from the customer about their selection process.
- Present data point 1. Isolate the first metric that the customer used to define success and explain how the product or solution helped to achieve this goal. Provide data points and quotes to substantiate the claim that success was achieved.
- Present data point 2. Isolate the second metric that the customer used to define success and explain what the product or solution did to achieve this goal. Provide data points and quotes to substantiate the claim that success was achieved.
- Present data point 3. Isolate the final metric that the customer used to define success and explain what the product or solution did to achieve this goal. Provide data points and quotes to substantiate the claim that success was achieved.
- Summarize the results. Reiterate the fact that the customer was able to achieve success thanks to a specific product or service. Include quotes and statements that reflect customer satisfaction and suggest they plan to continue using the solution.
- Ask for action. Include a CTA at the end of the case study that asks readers to reach out for more information, try a demo, or learn more — to further nurture them in the marketing pipeline. Again, remember that this is where marketers can look to convert their content into action with the customer.
While templates are helpful, seeing a case study in action can also be a great way to learn. Here are some examples of how Adobe customers have experienced success.
Juniper Networks
One example is the Adobe and Juniper Networks case study , which puts the reader in the customer’s shoes. The beginning of the story quickly orients the reader so that they know exactly who the article is about and what they were trying to achieve. Solutions are outlined in a way that shows Adobe Experience Manager is the best choice and a natural fit for the customer. Along the way, quotes from the client are incorporated to help add validity to the statements. The results in the case study are conveyed with clear evidence of scale and volume using tangible data.
The story of Lenovo’s journey with Adobe is one that spans years of planning, implementation, and rollout. The Lenovo case study does a great job of consolidating all of this into a relatable journey that other enterprise organizations can see themselves taking, despite the project size. This case study also features descriptive headers and compelling visual elements that engage the reader and strengthen the content.
Tata Consulting
When it comes to using data to show customer results, this case study does an excellent job of conveying details and numbers in an easy-to-digest manner. Bullet points at the start break up the content while also helping the reader understand exactly what the case study will be about. Tata Consulting used Adobe to deliver elevated, engaging content experiences for a large telecommunications client of its own — an objective that’s relatable for a lot of companies.
Case studies are a vital tool for any marketing team as they enable you to demonstrate the value of your company’s products and services to others. They help marketers do their job and add credibility to a brand trying to promote its solutions by using the experiences and stories of real customers.
When you’re ready to get started with a case study:
- Think about a few goals you’d like to accomplish with your content.
- Make a list of successful clients that would be strong candidates for a case study.
- Reach out to the client to get their approval and conduct an interview.
- Gather the data to present an engaging and effective customer story.
Adobe can help
There are several Adobe products that can help you craft compelling case studies. Adobe Experience Platform helps you collect data and deliver great customer experiences across every channel. Once you’ve created your case studies, Experience Platform will help you deliver the right information to the right customer at the right time for maximum impact.
To learn more, watch the Adobe Experience Platform story .
Keep in mind that the best case studies are backed by data. That’s where Adobe Real-Time Customer Data Platform and Adobe Analytics come into play. With Real-Time CDP, you can gather the data you need to build a great case study and target specific customers to deliver the content to the right audience at the perfect moment.
Watch the Real-Time CDP overview video to learn more.
Finally, Adobe Analytics turns real-time data into real-time insights. It helps your business collect and synthesize data from multiple platforms to make more informed decisions and create the best case study possible.
Request a demo to learn more about Adobe Analytics.
https://business.adobe.com/blog/perspectives/b2b-ecommerce-10-case-studies-inspire-you
https://business.adobe.com/blog/basics/business-case
https://business.adobe.com/blog/basics/what-is-real-time-analytics
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What Is a Case Study?
Weighing the pros and cons of this method of research
Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."
Cara Lustik is a fact-checker and copywriter.
Verywell / Colleen Tighe
- Pros and Cons
What Types of Case Studies Are Out There?
Where do you find data for a case study, how do i write a psychology case study.
A case study is an in-depth study of one person, group, or event. In a case study, nearly every aspect of the subject's life and history is analyzed to seek patterns and causes of behavior. Case studies can be used in many different fields, including psychology, medicine, education, anthropology, political science, and social work.
The point of a case study is to learn as much as possible about an individual or group so that the information can be generalized to many others. Unfortunately, case studies tend to be highly subjective, and it is sometimes difficult to generalize results to a larger population.
While case studies focus on a single individual or group, they follow a format similar to other types of psychology writing. If you are writing a case study, we got you—here are some rules of APA format to reference.
At a Glance
A case study, or an in-depth study of a person, group, or event, can be a useful research tool when used wisely. In many cases, case studies are best used in situations where it would be difficult or impossible for you to conduct an experiment. They are helpful for looking at unique situations and allow researchers to gather a lot of˜ information about a specific individual or group of people. However, it's important to be cautious of any bias we draw from them as they are highly subjective.
What Are the Benefits and Limitations of Case Studies?
A case study can have its strengths and weaknesses. Researchers must consider these pros and cons before deciding if this type of study is appropriate for their needs.
One of the greatest advantages of a case study is that it allows researchers to investigate things that are often difficult or impossible to replicate in a lab. Some other benefits of a case study:
- Allows researchers to capture information on the 'how,' 'what,' and 'why,' of something that's implemented
- Gives researchers the chance to collect information on why one strategy might be chosen over another
- Permits researchers to develop hypotheses that can be explored in experimental research
On the other hand, a case study can have some drawbacks:
- It cannot necessarily be generalized to the larger population
- Cannot demonstrate cause and effect
- It may not be scientifically rigorous
- It can lead to bias
Researchers may choose to perform a case study if they want to explore a unique or recently discovered phenomenon. Through their insights, researchers develop additional ideas and study questions that might be explored in future studies.
It's important to remember that the insights from case studies cannot be used to determine cause-and-effect relationships between variables. However, case studies may be used to develop hypotheses that can then be addressed in experimental research.
Case Study Examples
There have been a number of notable case studies in the history of psychology. Much of Freud's work and theories were developed through individual case studies. Some great examples of case studies in psychology include:
- Anna O : Anna O. was a pseudonym of a woman named Bertha Pappenheim, a patient of a physician named Josef Breuer. While she was never a patient of Freud's, Freud and Breuer discussed her case extensively. The woman was experiencing symptoms of a condition that was then known as hysteria and found that talking about her problems helped relieve her symptoms. Her case played an important part in the development of talk therapy as an approach to mental health treatment.
- Phineas Gage : Phineas Gage was a railroad employee who experienced a terrible accident in which an explosion sent a metal rod through his skull, damaging important portions of his brain. Gage recovered from his accident but was left with serious changes in both personality and behavior.
- Genie : Genie was a young girl subjected to horrific abuse and isolation. The case study of Genie allowed researchers to study whether language learning was possible, even after missing critical periods for language development. Her case also served as an example of how scientific research may interfere with treatment and lead to further abuse of vulnerable individuals.
Such cases demonstrate how case research can be used to study things that researchers could not replicate in experimental settings. In Genie's case, her horrific abuse denied her the opportunity to learn a language at critical points in her development.
This is clearly not something researchers could ethically replicate, but conducting a case study on Genie allowed researchers to study phenomena that are otherwise impossible to reproduce.
There are a few different types of case studies that psychologists and other researchers might use:
- Collective case studies : These involve studying a group of individuals. Researchers might study a group of people in a certain setting or look at an entire community. For example, psychologists might explore how access to resources in a community has affected the collective mental well-being of those who live there.
- Descriptive case studies : These involve starting with a descriptive theory. The subjects are then observed, and the information gathered is compared to the pre-existing theory.
- Explanatory case studies : These are often used to do causal investigations. In other words, researchers are interested in looking at factors that may have caused certain things to occur.
- Exploratory case studies : These are sometimes used as a prelude to further, more in-depth research. This allows researchers to gather more information before developing their research questions and hypotheses .
- Instrumental case studies : These occur when the individual or group allows researchers to understand more than what is initially obvious to observers.
- Intrinsic case studies : This type of case study is when the researcher has a personal interest in the case. Jean Piaget's observations of his own children are good examples of how an intrinsic case study can contribute to the development of a psychological theory.
The three main case study types often used are intrinsic, instrumental, and collective. Intrinsic case studies are useful for learning about unique cases. Instrumental case studies help look at an individual to learn more about a broader issue. A collective case study can be useful for looking at several cases simultaneously.
The type of case study that psychology researchers use depends on the unique characteristics of the situation and the case itself.
There are a number of different sources and methods that researchers can use to gather information about an individual or group. Six major sources that have been identified by researchers are:
- Archival records : Census records, survey records, and name lists are examples of archival records.
- Direct observation : This strategy involves observing the subject, often in a natural setting . While an individual observer is sometimes used, it is more common to utilize a group of observers.
- Documents : Letters, newspaper articles, administrative records, etc., are the types of documents often used as sources.
- Interviews : Interviews are one of the most important methods for gathering information in case studies. An interview can involve structured survey questions or more open-ended questions.
- Participant observation : When the researcher serves as a participant in events and observes the actions and outcomes, it is called participant observation.
- Physical artifacts : Tools, objects, instruments, and other artifacts are often observed during a direct observation of the subject.
If you have been directed to write a case study for a psychology course, be sure to check with your instructor for any specific guidelines you need to follow. If you are writing your case study for a professional publication, check with the publisher for their specific guidelines for submitting a case study.
Here is a general outline of what should be included in a case study.
Section 1: A Case History
This section will have the following structure and content:
Background information : The first section of your paper will present your client's background. Include factors such as age, gender, work, health status, family mental health history, family and social relationships, drug and alcohol history, life difficulties, goals, and coping skills and weaknesses.
Description of the presenting problem : In the next section of your case study, you will describe the problem or symptoms that the client presented with.
Describe any physical, emotional, or sensory symptoms reported by the client. Thoughts, feelings, and perceptions related to the symptoms should also be noted. Any screening or diagnostic assessments that are used should also be described in detail and all scores reported.
Your diagnosis : Provide your diagnosis and give the appropriate Diagnostic and Statistical Manual code. Explain how you reached your diagnosis, how the client's symptoms fit the diagnostic criteria for the disorder(s), or any possible difficulties in reaching a diagnosis.
Section 2: Treatment Plan
This portion of the paper will address the chosen treatment for the condition. This might also include the theoretical basis for the chosen treatment or any other evidence that might exist to support why this approach was chosen.
- Cognitive behavioral approach : Explain how a cognitive behavioral therapist would approach treatment. Offer background information on cognitive behavioral therapy and describe the treatment sessions, client response, and outcome of this type of treatment. Make note of any difficulties or successes encountered by your client during treatment.
- Humanistic approach : Describe a humanistic approach that could be used to treat your client, such as client-centered therapy . Provide information on the type of treatment you chose, the client's reaction to the treatment, and the end result of this approach. Explain why the treatment was successful or unsuccessful.
- Psychoanalytic approach : Describe how a psychoanalytic therapist would view the client's problem. Provide some background on the psychoanalytic approach and cite relevant references. Explain how psychoanalytic therapy would be used to treat the client, how the client would respond to therapy, and the effectiveness of this treatment approach.
- Pharmacological approach : If treatment primarily involves the use of medications, explain which medications were used and why. Provide background on the effectiveness of these medications and how monotherapy may compare with an approach that combines medications with therapy or other treatments.
This section of a case study should also include information about the treatment goals, process, and outcomes.
When you are writing a case study, you should also include a section where you discuss the case study itself, including the strengths and limitiations of the study. You should note how the findings of your case study might support previous research.
In your discussion section, you should also describe some of the implications of your case study. What ideas or findings might require further exploration? How might researchers go about exploring some of these questions in additional studies?
Need More Tips?
Here are a few additional pointers to keep in mind when formatting your case study:
- Never refer to the subject of your case study as "the client." Instead, use their name or a pseudonym.
- Read examples of case studies to gain an idea about the style and format.
- Remember to use APA format when citing references .
Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011;11:100.
Crowe S, Cresswell K, Robertson A, Huby G, Avery A, Sheikh A. The case study approach . BMC Med Res Methodol . 2011 Jun 27;11:100. doi:10.1186/1471-2288-11-100
Gagnon, Yves-Chantal. The Case Study as Research Method: A Practical Handbook . Canada, Chicago Review Press Incorporated DBA Independent Pub Group, 2010.
Yin, Robert K. Case Study Research and Applications: Design and Methods . United States, SAGE Publications, 2017.
By Kendra Cherry, MSEd Kendra Cherry, MS, is a psychosocial rehabilitation specialist, psychology educator, and author of the "Everything Psychology Book."
Organizing Your Social Sciences Research Assignments
- Annotated Bibliography
- Analyzing a Scholarly Journal Article
- Group Presentations
- Dealing with Nervousness
- Using Visual Aids
- Grading Someone Else's Paper
- Types of Structured Group Activities
- Group Project Survival Skills
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- Multiple Book Review Essay
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- Writing a Case Analysis Paper
- Writing a Case Study
- About Informed Consent
- Writing Field Notes
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- Generative AI and Writing
- Acknowledgments
A case study research paper examines a person, place, event, condition, phenomenon, or other type of subject of analysis in order to extrapolate key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study research paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or more subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.
Case Studies. Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.
How to Approach Writing a Case Study Research Paper
General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in the Organizing Your Social Sciences Research Paper writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a case study design.
However, identifying a case to investigate involves more than choosing the research problem . A case study encompasses a problem contextualized around the application of in-depth analysis, interpretation, and discussion, often resulting in specific recommendations for action or for improving existing conditions. As Seawright and Gerring note, practical considerations such as time and access to information can influence case selection, but these issues should not be the sole factors used in describing the methodological justification for identifying a particular case to study. Given this, selecting a case includes considering the following:
- The case represents an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
- The case provides important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
- The case challenges and offers a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in current practice. A case study analysis may offer an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
- The case provides an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings so as to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
- The case offers a new direction in future research? A case study can be used as a tool for an exploratory investigation that highlights the need for further research about the problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of east central Africa. A case study of how women contribute to saving water in a rural village of Uganda can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community. This example of a case study could also point to the need for scholars to build new theoretical frameworks around the topic [e.g., applying feminist theories of work and family to the issue of water conservation].
Eisenhardt, Kathleen M. “Building Theories from Case Study Research.” Academy of Management Review 14 (October 1989): 532-550; Emmel, Nick. Sampling and Choosing Cases in Qualitative Research: A Realist Approach . Thousand Oaks, CA: SAGE Publications, 2013; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Seawright, Jason and John Gerring. "Case Selection Techniques in Case Study Research." Political Research Quarterly 61 (June 2008): 294-308.
Structure and Writing Style
The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work.
In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.
I. Introduction
As with any research paper, your introduction should serve as a roadmap for your readers to ascertain the scope and purpose of your study . The introduction to a case study research paper, however, should not only describe the research problem and its significance, but you should also succinctly describe why the case is being used and how it relates to addressing the problem. The two elements should be linked. With this in mind, a good introduction answers these four questions:
- What is being studied? Describe the research problem and describe the subject of analysis [the case] you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
- Why is this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
- What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
- How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.
Each of these questions should be addressed in no more than a few paragraphs. Exceptions to this can be when you are addressing a complex research problem or subject of analysis that requires more in-depth background information.
II. Literature Review
The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and enabling historical interpretation of the subject of analysis in relation to the research problem the case is intended to address . This includes synthesizing studies that help to:
- Place relevant works in the context of their contribution to understanding the case study being investigated . This would involve summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
- Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to investigate the research problem and the underlying research questions.
- Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your use of a case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
- Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
- Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
- Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
- Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in relation to explaining the relevance of the case in addressing the research problem.
III. Method
In this section, you explain why you selected a particular case [i.e., subject of analysis] and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that constitutes your case study.
If your subject of analysis is an incident or event . In the social and behavioral sciences, the event or incident that represents the case to be studied is usually bounded by time and place, with a clear beginning and end and with an identifiable location or position relative to its surroundings. The subject of analysis can be a rare or critical event or it can focus on a typical or regular event. The purpose of studying a rare event is to illuminate new ways of thinking about the broader research problem or to test a hypothesis. Critical incident case studies must describe the method by which you identified the event and explain the process by which you determined the validity of this case to inform broader perspectives about the research problem or to reveal new findings. However, the event does not have to be a rare or uniquely significant to support new thinking about the research problem or to challenge an existing hypothesis. For example, Walo, Bull, and Breen conducted a case study to identify and evaluate the direct and indirect economic benefits and costs of a local sports event in the City of Lismore, New South Wales, Australia. The purpose of their study was to provide new insights from measuring the impact of a typical local sports event that prior studies could not measure well because they focused on large "mega-events." Whether the event is rare or not, the methods section should include an explanation of the following characteristics of the event: a) when did it take place; b) what were the underlying circumstances leading to the event; and, c) what were the consequences of the event in relation to the research problem.
If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experiences they have had that provide an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of their experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using them as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem [e.g., why is one politician in a particular local election used to show an increase in voter turnout from any other candidate running in the election]. Note that these issues apply to a specific group of people used as a case study unit of analysis [e.g., a classroom of students].
If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, historical, cultural, economic, political], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, explain why you are studying Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research suggests Echo Park has more homeless veterans].
If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut off? How might knowing the suppliers of these trucks reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.
NOTE: The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should clearly support investigation of the research problem and linked to key findings from your literature review. Be sure to cite any studies that helped you determine that the case you chose was appropriate for examining the problem.
IV. Discussion
The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your analysis of the case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is common to combine a description of the results with the discussion about their implications. The objectives of your discussion section should include the following:
Reiterate the Research Problem/State the Major Findings Briefly reiterate the research problem you are investigating and explain why the subject of analysis around which you designed the case study were used. You should then describe the findings revealed from your study of the case using direct, declarative, and succinct proclamation of the study results. Highlight any findings that were unexpected or especially profound.
Explain the Meaning of the Findings and Why They are Important Systematically explain the meaning of your case study findings and why you believe they are important. Begin this part of the section by repeating what you consider to be your most important or surprising finding first, then systematically review each finding. Be sure to thoroughly extrapolate what your analysis of the case can tell the reader about situations or conditions beyond the actual case that was studied while, at the same time, being careful not to misconstrue or conflate a finding that undermines the external validity of your conclusions.
Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.
Consider Alternative Explanations of the Findings Remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations revealed by the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research if that is how the findings can be interpreted from your case.
Acknowledge the Study's Limitations You can state the study's limitations in the conclusion section of your paper but describing the limitations of your subject of analysis in the discussion section provides an opportunity to identify the limitations and explain why they are not significant. This part of the discussion section should also note any unanswered questions or issues your case study could not address. More detailed information about how to document any limitations to your research can be found here .
Suggest Areas for Further Research Although your case study may offer important insights about the research problem, there are likely additional questions related to the problem that remain unanswered or findings that unexpectedly revealed themselves as a result of your in-depth analysis of the case. Be sure that the recommendations for further research are linked to the research problem and that you explain why your recommendations are valid in other contexts and based on the original assumptions of your study.
V. Conclusion
As with any research paper, you should summarize your conclusion in clear, simple language; emphasize how the findings from your case study differs from or supports prior research and why. Do not simply reiterate the discussion section. Provide a synthesis of key findings presented in the paper to show how these converge to address the research problem. If you haven't already done so in the discussion section, be sure to document the limitations of your case study and any need for further research.
The function of your paper's conclusion is to: 1) reiterate the main argument supported by the findings from your case study; 2) state clearly the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.
Consider the following points to help ensure your conclusion is appropriate:
- If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
- If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
- Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.
Note that, depending on the discipline you are writing in or the preferences of your professor, the concluding paragraph may contain your final reflections on the evidence presented as it applies to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.
Problems to Avoid
Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were engaged with social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.
Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood more in terms of managing access rather than preserving access to a scarce resource.
Failure to Extrapolate All Possible Implications Just as you don't want to over-generalize from your case study findings, you also have to be thorough in the consideration of all possible outcomes or recommendations derived from your findings. If you do not, your reader may question the validity of your analysis, particularly if you failed to document an obvious outcome from your case study research. For example, in the case of studying the accident at the railroad crossing to evaluate where and what types of warning signals should be located, you failed to take into consideration speed limit signage as well as warning signals. When designing your case study, be sure you have thoroughly addressed all aspects of the problem and do not leave gaps in your analysis that leave the reader questioning the results.
Case Studies. Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009; Kratochwill, Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education . Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.
Writing Tip
At Least Five Misconceptions about Case Study Research
Social science case studies are often perceived as limited in their ability to create new knowledge because they are not randomly selected and findings cannot be generalized to larger populations. Flyvbjerg examines five misunderstandings about case study research and systematically "corrects" each one. To quote, these are:
Misunderstanding 1 : General, theoretical [context-independent] knowledge is more valuable than concrete, practical [context-dependent] knowledge. Misunderstanding 2 : One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 : The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 : The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 : It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].
While writing your paper, think introspectively about how you addressed these misconceptions because to do so can help you strengthen the validity and reliability of your research by clarifying issues of case selection, the testing and challenging of existing assumptions, the interpretation of key findings, and the summation of case outcomes. Think of a case study research paper as a complete, in-depth narrative about the specific properties and key characteristics of your subject of analysis applied to the research problem.
Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.
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Meaning of case study in English
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- anti-narrative
- be another story idiom
- bodice-ripper
- cautionary tale
- misdescription
- multi-stranded
- running commentary phrase
- semi-legendary
- shaggy-dog story
- short story
- write something up
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Definition of case study
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1914, in the meaning defined at sense 1
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What is a Case Study? [+6 Types of Case Studies]
By Ronita Mohan , Sep 20, 2021
Case studies have become powerful business tools. But what is a case study? What are the benefits of creating one? Are there limitations to the format?
If you’ve asked yourself these questions, our helpful guide will clear things up. Learn how to use a case study for business. Find out how cases analysis works in psychology and research.
We’ve also got examples of case studies to inspire you.
Haven’t made a case study before? You can easily create a case study with Venngage’s customizable templates.
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What is a case study, what is the case study method, benefits of case studies, limitations of case studies, types of case studies, faqs about case studies.
Case studies are research methodologies. They examine subjects, projects, or organizations to tell a story.
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Numerous sectors use case analyses. The social sciences, social work, and psychology create studies regularly.
Healthcare industries write reports on patients and diagnoses. Marketing case study examples , like the one below, highlight the benefits of a business product.
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Now that you know what a case study is, we explain how case reports are used in three different industries.
What is a business case study?
A business or marketing case study aims at showcasing a successful partnership. This can be between a brand and a client. Or the case study can examine a brand’s project.
There is a perception that case studies are used to advertise a brand. But effective reports, like the one below, can show clients how a brand can support them.
Hubspot created a case study on a customer that successfully scaled its business. The report outlines the various Hubspot tools used to achieve these results.
Hubspot also added a video with testimonials from the client company’s employees.
So, what is the purpose of a case study for businesses? There is a lot of competition in the corporate world. Companies are run by people. They can be on the fence about which brand to work with.
Business reports stand out aesthetically, as well. They use brand colors and brand fonts . Usually, a combination of the client’s and the brand’s.
With the Venngage My Brand Kit feature, businesses can automatically apply their brand to designs.
A business case study, like the one below, acts as social proof. This helps customers decide between your brand and your competitors.
Don’t know how to design a report? You can learn how to write a case study with Venngage’s guide. We also share design tips and examples that will help you convert.
Related: 55+ Annual Report Design Templates, Inspirational Examples & Tips [Updated]
What is a case study in psychology?
In the field of psychology, case studies focus on a particular subject. Psychology case histories also examine human behaviors.
Case reports search for commonalities between humans. They are also used to prescribe further research. Or these studies can elaborate on a solution for a behavioral ailment.
The American Psychology Association has a number of case studies on real-life clients. Note how the reports are more text-heavy than a business case study.
Famous psychologists such as Sigmund Freud and Anna O popularised the use of case studies in the field. They did so by regularly interviewing subjects. Their detailed observations build the field of psychology.
It is important to note that psychological studies must be conducted by professionals. Psychologists, psychiatrists and therapists should be the researchers in these cases.
Related: What Netflix’s Top 50 Shows Can Teach Us About Font Psychology [Infographic]
What is a case study in research?
Research is a necessary part of every case study. But specific research fields are required to create studies. These fields include user research, healthcare, education, or social work.
For example, this UX Design report examined the public perception of a client. The brand researched and implemented new visuals to improve it. The study breaks down this research through lessons learned.
Clinical reports are a necessity in the medical field. These documents are used to share knowledge with other professionals. They also help examine new or unusual diseases or symptoms.
The pandemic has led to a significant increase in research. For example, Spectrum Health studied the value of health systems in the pandemic. They created the study by examining community outreach.
The pandemic has significantly impacted the field of education. This has led to numerous examinations on remote studying. There have also been studies on how students react to decreased peer communication.
Social work case reports often have a community focus. They can also examine public health responses. In certain regions, social workers study disaster responses.
You now know what case studies in various fields are. In the next step of our guide, we explain the case study method.
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A case analysis is a deep dive into a subject. To facilitate this case studies are built on interviews and observations. The below example would have been created after numerous interviews.
Case studies are largely qualitative. They analyze and describe phenomena. While some data is included, a case analysis is not quantitative.
There are a few steps in the case method. You have to start by identifying the subject of your study. Then determine what kind of research is required.
In natural sciences, case studies can take years to complete. Business reports, like this one, don’t take that long. A few weeks of interviews should be enough.
The case method will vary depending on the industry. Reports will also look different once produced.
As you will have seen, business reports are more colorful. The design is also more accessible . Healthcare and psychology reports are more text-heavy.
Designing case reports takes time and energy. So, is it worth taking the time to write them? Here are the benefits of creating case studies.
- Collects large amounts of information
- Helps formulate hypotheses
- Builds the case for further research
- Discovers new insights into a subject
- Builds brand trust and loyalty
- Engages customers through stories
For example, the business study below creates a story around a brand partnership. It makes for engaging reading. The study also shows evidence backing up the information.
We’ve shared the benefits of why studies are needed. We will also look at the limitations of creating them.
Related: How to Present a Case Study like a Pro (With Examples)
There are a few disadvantages to conducting a case analysis. The limitations will vary according to the industry.
- Responses from interviews are subjective
- Subjects may tailor responses to the researcher
- Studies can’t always be replicated
- In certain industries, analyses can take time and be expensive
- Risk of generalizing the results among a larger population
These are some of the common weaknesses of creating case reports. If you’re on the fence, look at the competition in your industry.
Other brands or professionals are building reports, like this example. In that case, you may want to do the same.
There are six common types of case reports. Depending on your industry, you might use one of these types.
Descriptive case studies
Explanatory case studies, exploratory case reports, intrinsic case studies, instrumental case studies, collective case reports.
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We go into more detail about each type of study in the guide below.
Related: 15+ Professional Case Study Examples [Design Tips + Templates]
When you have an existing hypothesis, you can design a descriptive study. This type of report starts with a description. The aim is to find connections between the subject being studied and a theory.
Once these connections are found, the study can conclude. The results of this type of study will usually suggest how to develop a theory further.
A study like the one below has concrete results. A descriptive report would use the quantitative data as a suggestion for researching the subject deeply.
When an incident occurs in a field, an explanation is required. An explanatory report investigates the cause of the event. It will include explanations for that cause.
The study will also share details about the impact of the event. In most cases, this report will use evidence to predict future occurrences. The results of explanatory reports are definitive.
Note that there is no room for interpretation here. The results are absolute.
The study below is a good example. It explains how one brand used the services of another. It concludes by showing definitive proof that the collaboration was successful.
Another example of this study would be in the automotive industry. If a vehicle fails a test, an explanatory study will examine why. The results could show that the failure was because of a particular part.
Related: How to Write a Case Study [+ Design Tips]
An explanatory report is a self-contained document. An exploratory one is only the beginning of an investigation.
Exploratory cases act as the starting point of studies. This is usually conducted as a precursor to large-scale investigations. The research is used to suggest why further investigations are needed.
An exploratory study can also be used to suggest methods for further examination.
For example, the below analysis could have found inconclusive results. In that situation, it would be the basis for an in-depth study.
Intrinsic studies are more common in the field of psychology. These reports can also be conducted in healthcare or social work.
These types of studies focus on a unique subject, such as a patient. They can sometimes study groups close to the researcher.
The aim of such studies is to understand the subject better. This requires learning their history. The researcher will also examine how they interact with their environment.
For instance, if the case study below was about a unique brand, it could be an intrinsic study.
Once the study is complete, the researcher will have developed a better understanding of a phenomenon. This phenomenon will likely not have been studied or theorized about before.
Examples of intrinsic case analysis can be found across psychology. For example, Jean Piaget’s theories on cognitive development. He established the theory from intrinsic studies into his own children.
Related: What Disney Villains Can Tell Us About Color Psychology [Infographic]
This is another type of study seen in medical and psychology fields. Instrumental reports are created to examine more than just the primary subject.
When research is conducted for an instrumental study, it is to provide the basis for a larger phenomenon. The subject matter is usually the best example of the phenomenon. This is why it is being studied.
Assume it’s examining lead generation strategies. It may want to show that visual marketing is the definitive lead generation tool. The brand can conduct an instrumental case study to examine this phenomenon.
Collective studies are based on instrumental case reports. These types of studies examine multiple reports.
There are a number of reasons why collective reports are created:
- To provide evidence for starting a new study
- To find pattens between multiple instrumental reports
- To find differences in similar types of cases
- Gain a deeper understanding of a complex phenomenon
- Understand a phenomenon from diverse contexts
A researcher could use multiple reports, like the one below, to build a collective case report.
Related: 10+ Case Study Infographic Templates That Convert
What makes a case study a case study?
A case study has a very particular research methodology. They are an in-depth study of a person or a group of individuals. They can also study a community or an organization. Case reports examine real-world phenomena within a set context.
How long should a case study be?
The length of studies depends on the industry. It also depends on the story you’re telling. Most case studies should be at least 500-1500 words long. But you can increase the length if you have more details to share.
What should you ask in a case study?
The one thing you shouldn’t ask is ‘yes’ or ‘no’ questions. Case studies are qualitative. These questions won’t give you the information you need.
Ask your client about the problems they faced. Ask them about solutions they found. Or what they think is the ideal solution. Leave room to ask them follow-up questions. This will help build out the study.
How to present a case study?
When you’re ready to present a case study, begin by providing a summary of the problem or challenge you were addressing. Follow this with an outline of the solution you implemented, and support this with the results you achieved, backed by relevant data. Incorporate visual aids like slides, graphs, and images to make your case study presentation more engaging and impactful.
Now you know what a case study means, you can begin creating one. These reports are a great tool for analyzing brands. They are also useful in a variety of other fields.
Use a visual communication platform like Venngage to design case studies. With Venngage’s templates, you can design easily. Create branded, engaging reports, all without design experience.
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Home » Case Study – Methods, Examples and Guide
Case Study – Methods, Examples and Guide
Table of Contents
A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.
It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.
Types of Case Study
Types and Methods of Case Study are as follows:
Single-Case Study
A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.
For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.
Multiple-Case Study
A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.
For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.
Exploratory Case Study
An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.
For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.
Descriptive Case Study
A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.
For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.
Instrumental Case Study
An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.
For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.
Case Study Data Collection Methods
Here are some common data collection methods for case studies:
Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.
Observations
Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.
Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.
Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.
Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.
How to conduct Case Study Research
Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:
- Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
- Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
- Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
- Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
- Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
- Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
- Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.
Examples of Case Study
Here are some examples of case study research:
- The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
- The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
- The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
- The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
- The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.
Application of Case Study
Case studies have a wide range of applications across various fields and industries. Here are some examples:
Business and Management
Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.
Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.
Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.
Social Sciences
Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.
Law and Ethics
Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.
Purpose of Case Study
The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.
The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.
Case studies can also serve other purposes, including:
- Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
- Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
- Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
- Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
Advantages of Case Study Research
There are several advantages of case study research, including:
- In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
- Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
- Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
- Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
- Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
- Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.
Limitations of Case Study Research
There are several limitations of case study research, including:
- Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
- Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
- Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
- Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
- Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
- Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.
About the author
Muhammad Hassan
Researcher, Academic Writer, Web developer
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Many writers find themselves grappling with the challenge of crafting persuasive and engaging case studies.
The process can be overwhelming, leaving them unsure where to begin or how to structure their study effectively. And, without a clear plan, it's tough to show the value and impact in a convincing way.
But don’t worry!
In this blog, we'll guide you through a systematic process, offering step-by-step instructions on crafting a compelling case study.
Along the way, we'll share valuable tips and illustrative examples to enhance your understanding. So, let’s get started.
- 1. What is a Case Study?
- 2. Types of Case Studies
- 3. How To Write a Case Study - 9 Steps
- 4. Case Study Methods
- 5. Case Study Format
- 6. Case Study Examples
- 7. Benefits and Limitations of Case Studies
What is a Case Study?
A case study is a detailed analysis and examination of a particular subject, situation, or phenomenon. It involves comprehensive research to gain a deep understanding of the context and variables involved.
Typically used in academic, business, and marketing settings, case studies aim to explore real-life scenarios, providing insights into challenges, solutions, and outcomes. They serve as valuable tools for learning, decision-making, and showcasing success stories.
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Types of Case Studies
Case studies come in various forms, each tailored to address specific objectives and areas of interest. Here are some of the main types of case studies :
- Illustrative Case Studies: These focus on describing a particular situation or event, providing a detailed account to enhance understanding.
- Exploratory Case Studies: Aimed at investigating an issue and generating initial insights, these studies are particularly useful when exploring new or complex topics.
- Explanatory Case Studies: These delve into the cause-and-effect relationships within a given scenario, aiming to explain why certain outcomes occurred.
- Intrinsic Case Studies: Concentrating on a specific case that holds intrinsic value, these studies explore the unique qualities of the subject itself.
- Instrumental Case Studies: These are conducted to understand a broader issue and use the specific case as a means to gain insights into the larger context.
- Collective Case Studies: Involving the study of multiple cases, this type allows for comparisons and contrasts, offering a more comprehensive view of a phenomenon or problem.
How To Write a Case Study - 9 Steps
Crafting an effective case study involves a structured approach to ensure clarity, engagement, and relevance.
Here's a step-by-step guide on how to write a compelling case study:
Step 1: Define Your Objective
Before diving into the writing process, clearly define the purpose of your case study. Identify the key questions you want to answer and the specific goals you aim to achieve.
Whether it's to showcase a successful project, analyze a problem, or demonstrate the effectiveness of a solution, a well-defined objective sets the foundation for a focused and impactful case study.
Step 2: Conduct Thorough Research
Gather all relevant information and data related to your chosen case. This may include interviews, surveys, documentation, and statistical data.
Ensure that your research is comprehensive, covering all aspects of the case to provide a well-rounded and accurate portrayal.
The more thorough your research, the stronger your case study's foundation will be.
Step 3: Introduction: Set the Stage
Begin your case study with a compelling introduction that grabs the reader's attention. Clearly state the subject and the primary issue or challenge faced.
Engage your audience by setting the stage for the narrative, creating intrigue, and highlighting the significance of the case.
Step 4: Present the Background Information
Provide context by presenting the background information of the case. Explore relevant history, industry trends, and any other factors that contribute to a deeper understanding of the situation.
This section sets the stage for readers, allowing them to comprehend the broader context before delving into the specifics of the case.
Step 5: Outline the Challenges Faced
Identify and articulate the challenges or problems encountered in the case. Clearly define the obstacles that needed to be overcome, emphasizing their significance.
This section sets the stakes for your audience and prepares them for the subsequent exploration of solutions.
Step 6: Detail the Solutions Implemented
Describe the strategies, actions, or solutions applied to address the challenges outlined. Be specific about the decision-making process, the rationale behind the chosen solutions, and any alternatives considered.
This part of the case study demonstrates problem-solving skills and showcases the effectiveness of the implemented measures.
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Step 7: Showcase Measurable Results
Present tangible outcomes and results achieved as a direct consequence of the implemented solutions. Use data, metrics, and success stories to quantify the impact.
Whether it's increased revenue, improved efficiency, or positive customer feedback, measurable results add credibility and validation to your case study.
Step 8: Include Engaging Visuals
Enhance the readability and visual appeal of your case study by incorporating relevant visuals such as charts, graphs, images, and infographics.
Visual elements not only break up the text but also provide a clearer representation of data and key points, making your case study more engaging and accessible.
Step 9: Provide a Compelling Conclusion
Wrap up your case study with a strong and conclusive summary. Revisit the initial objectives, recap key findings, and emphasize the overall success or significance of the case.
This section should leave a lasting impression on your readers, reinforcing the value of the presented information.
Case Study Methods
The methods employed in case study writing are diverse and flexible, catering to the unique characteristics of each case. Here are common methods used in case study writing:
Conducting one-on-one or group interviews with individuals involved in the case to gather firsthand information, perspectives, and insights.
- Observation
Directly observing the subject or situation to collect data on behaviors, interactions, and contextual details.
- Document Analysis
Examining existing documents, records, reports, and other written materials relevant to the case to gather information and insights.
- Surveys and Questionnaires
Distributing structured surveys or questionnaires to relevant stakeholders to collect quantitative data on specific aspects of the case.
- Participant Observation
Combining direct observation with active participation in the activities or events related to the case to gain an insider's perspective.
- Triangulation
Using multiple methods (e.g., interviews, observation, and document analysis) to cross-verify and validate the findings, enhancing the study's reliability.
- Ethnography
Immersing the researcher in the subject's environment over an extended period, focusing on understanding the cultural context and social dynamics.
Case Study Format
Effectively presenting your case study is as crucial as the content itself. Follow these formatting guidelines to ensure clarity and engagement:
- Opt for fonts that are easy to read, such as Arial, Calibri, or Times New Roman.
- Maintain a consistent font size, typically 12 points for the body text.
- Aim for double-line spacing to maintain clarity and prevent overwhelming the reader with too much text.
- Utilize bullet points to present information in a concise and easily scannable format.
- Use numbered lists when presenting a sequence of steps or a chronological order of events.
- Bold or italicize key phrases or important terms to draw attention to critical points.
- Use underline sparingly, as it can sometimes be distracting in digital formats.
- Choose the left alignment style.
- Use hierarchy to distinguish between different levels of headings, making it easy for readers to navigate.
If you're still having trouble organizing your case study, check out this blog on case study format for helpful insights.
Case Study Examples
If you want to understand how to write a case study, examples are a fantastic way to learn. That's why we've gathered a collection of intriguing case study examples for you to review before you begin writing.
Case Study Research Example
Case Study Template
Case Study Introduction Example
Amazon Case Study Example
Business Case Study Example
APA Format Case Study Example
Psychology Case Study Example
Medical Case Study Example
UX Case Study Example
Looking for more examples? Check out our blog on case study examples for your inspiration!
Benefits and Limitations of Case Studies
Case studies are a versatile and in-depth research method, providing a nuanced understanding of complex phenomena.
However, like any research approach, case studies come with their set of benefits and limitations. Some of them are given below:
Tips for Writing an Effective Case Study
Here are some important tips for writing a good case study:
- Clearly articulate specific, measurable research questions aligned with your objectives.
- Identify whether your case study is exploratory, explanatory, intrinsic, or instrumental.
- Choose a case that aligns with your research questions, whether it involves an individual case or a group of people through multiple case studies.
- Explore the option of conducting multiple case studies to enhance the breadth and depth of your findings.
- Present a structured format with clear sections, ensuring readability and alignment with the type of research.
- Clearly define the significance of the problem or challenge addressed in your case study, tying it back to your research questions.
- Collect and include quantitative and qualitative data to support your analysis and address the identified research questions.
- Provide sufficient detail without overwhelming your audience, ensuring a comprehensive yet concise presentation.
- Emphasize how your findings can be practically applied to real-world situations, linking back to your research objectives.
- Acknowledge and transparently address any limitations in your study, ensuring a comprehensive and unbiased approach.
To sum it up, creating a good case study involves careful thinking to share valuable insights and keep your audience interested.
Stick to basics like having clear questions and understanding your research type. Choose the right case and keep things organized and balanced.
Remember, your case study should tackle a problem, use relevant data, and show how it can be applied in real life. Be honest about any limitations, and finish with a clear call-to-action to encourage further exploration.
However, if you are having issues understanding how to write a case study, it is best to hire the professionals. Hiring a paper writing service online will ensure that you will get best grades on your essay without any stress of a deadline.
So be sure to check out case study writing service online and stay up to the mark with your grades.
Frequently Asked Questions
What is the purpose of a case study.
The objective of a case study is to do intensive research on a specific matter, such as individuals or communities. It's often used for academic purposes where you want the reader to know all factors involved in your subject while also understanding the processes at play.
What are the sources of a case study?
Some common sources of a case study include:
- Archival records
- Direct observations and encounters
- Participant observation
- Facts and statistics
- Physical artifacts
What is the sample size of a case study?
A normally acceptable size of a case study is 30-50. However, the final number depends on the scope of your study and the on-ground demographic realities.
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Dr. Barbara is a highly experienced writer and author who holds a Ph.D. degree in public health from an Ivy League school. She has worked in the medical field for many years, conducting extensive research on various health topics. Her writing has been featured in several top-tier publications.
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Nursing Case Studies with Answers
Explore Nursing Case Studies with Answers and examples in Carepatron's free downloadable PDF. Enhance your nursing knowledge and prepare for exams with practical scenarios.
By Wynona Jugueta on Mar 25, 2024.
Fact Checked by Ericka Pingol.
What is a case study?
A case study in medicine is a detailed report of a patient's experience with a disease, treatment, or condition. It typically includes the patient's medical history, symptoms, diagnostic tests, treatment course, and outcome.
Some key things to know about medical case studies template . First, they delve deep into the specifics of a single case, providing a rich understanding of a particular medical situation.
Medical professionals use case studies to learn about rare diseases, unusual presentations of common conditions, and the decision-making process involved in complex cases.
Case studies can identify exciting areas for further investigation through more rigorous clinical trials. While informative, they can't be used to develop general treatment guidelines because they only focus on a single case.
Overall, medical case studies are valuable tools for medical education and research, offering insights into human health and disease complexities.
Printable Nursing Case Studies with Answers
Download this Nursing Case Studies with Answers to analyze complex clinical situations, identify priority needs, and develop effective care plans tailored to individual patients.
What is in a nursing case study?
A nursing case study is a detailed examination of a patient's health condition, treatment plan, and overall care journey, specifically from the perspective of nursing practice. These case studies are essential components of nursing education and professional development, providing valuable insights into clinical scenarios and patient care experiences.
In a case nursing study template , various elements are typically included to comprehensively understand the patient's situation. First and foremost, the case study outlines the patient's demographic information, including age, gender, medical history, and presenting symptoms. This demographic overview sets the stage for understanding the context in which healthcare interventions occur.
Moreover, nursing case studies often delve into the nursing assessment process, highlighting the initial and ongoing assessments nurses conduct to gather relevant patient health status data. These assessments involve physical examinations, vital sign monitoring, and assessment tools to identify potential health issues and risk factors.
Critical thinking skills are essential in nursing case studies, as they enable nurses to analyze complex clinical situations, identify priority needs, and develop effective care plans tailored to individual patients. Nursing students and experienced nurses use case studies as opportunities to enhance their critical thinking abilities and clinical decision-making processes.
Nursing case studies serve several vital purposes within healthcare education and professional practice, whether they are a primary care physician or a group of nursing students. Let's explore each purpose in detail:
Enhancing clinical reasoning skills
One primary purpose of nursing case studies is to enhance nursing students' and practicing nurses' clinical reasoning skills. By presenting realistic patient scenarios, case studies challenge individuals to analyze clinical data, interpret findings, and develop appropriate nursing interventions. This process promotes critical thinking and problem-solving abilities essential for effective nursing practice.
Applying theoretical knowledge to practice
Nursing case studies provide a bridge between theoretical knowledge and practical application. They allow nursing students to apply concepts learned in the classroom to real-world patient care situations. By engaging with case studies, students can integrate theoretical principles with clinical practice, gaining a deeper understanding of nursing concepts and their relevance to patient care.
Facilitating interdisciplinary collaboration
Another purpose of nursing case studies is to facilitate interdisciplinary collaboration among healthcare professionals. Nurses often collaborate with physicians, specialists, therapists, and other team members in complex patient cases to deliver comprehensive care. Case studies offer opportunities for nurses to explore collaborative decision-making processes, communication strategies, and teamwork dynamics essential for providing quality patient care.
Promoting evidence-based practice
Nursing case studies are crucial in promoting evidence-based practice (EBP) within nursing and healthcare settings. Nurses can make informed decisions about patient care interventions by analyzing patient scenarios and considering current research evidence. Case studies encourage nurses to critically evaluate research findings, clinical guidelines, and best practices to ensure the delivery of safe, effective, and patient-centered care.
Fostering professional development
Engaging with nursing case studies contributes to the ongoing professional development of nurses at all stages of their careers. For nursing students, case studies provide valuable learning experiences that help prepare them for clinical practice. For experienced nurses, case studies offer opportunities to refine clinical skills, stay updated on emerging healthcare trends, and reflect on past experiences to improve future practice.
How to write a nursing case study?
Writing a nursing case study involves several essential steps to ensure accuracy, relevance, and clarity. Let's break down the process into actionable steps:
Step 1: Select a patient case
Begin by selecting a patient case that presents a relevant and compelling healthcare scenario. Consider factors such as the patient's demographic information, medical history, presenting symptoms (e.g., joint stiffness, pain), and healthcare needs (e.g., medication administration, vital signs monitoring). Choose a case that aligns with your learning objectives and offers meaningful analysis and discussion opportunities.
Step 2: Gather relevant data
Collect comprehensive data about the selected patient case, including medical records, test results, nursing assessments, and relevant healthcare documentation. Pay close attention to details such as the patient's current health status, past medical history (e.g., diabetes), treatment plans, and any ongoing concerns or challenges. Utilize assessment tools and techniques to evaluate the patient's condition thoroughly and identify areas of clinical significance.
Step 3: Assess the patient's needs
Based on the gathered data, evaluate the patient's needs, considering physical, emotional, social, and environmental factors. Assess the patient's pain levels, mobility, vital signs, and other relevant health indicators. Identify any potential complications, risks, or areas requiring immediate attention. Consider the patient's preferences, cultural background, and individualized care requirements in your assessment.
Step 4: Formulate nursing diagnoses
Formulate nursing diagnoses that accurately reflect the patient's health needs and priorities based on your assessment findings. Identify actual and potential nursing diagnoses related to the patient's condition, considering factors such as impaired mobility, ineffective pain management, medication adherence issues, and self-care deficits. Ensure your nursing diagnoses are specific, measurable, achievable, relevant, and time-bound (SMART).
Step 5: Develop a care plan
Develop a comprehensive care plan outlining the nursing interventions and strategies to address the patient's identified needs and nursing diagnoses. Prioritize interventions based on the patient's condition, preferences, and care goals. Include evidence-based nursing interventions to promote optimal health outcomes, manage symptoms, prevent complications, and enhance the patient's overall well-being. Collaborate with other healthcare professionals as needed to ensure coordinated care delivery.
Step 6: Implement and evaluate interventions
Implement the nursing interventions outlined in the care plan while closely monitoring the patient's response to treatment. Administer medications, provide patient education, perform nursing procedures, and coordinate care activities to effectively meet the patient's needs. Continuously evaluate the effectiveness of interventions, reassessing the patient's condition and adjusting the care plan as necessary. Document all interventions, observations, and outcomes accurately and comprehensively.
Step 7: Reflect and seek assistance
Reflect on the nursing case study process, considering what worked well, areas for improvement, and lessons learned. Seek assistance from nursing instructors, preceptors, or colleagues if you encounter challenges or have concerns about the patient's care. Collaborate with interdisciplinary team members to address complex patient issues and ensure holistic care delivery. Continuously strive to enhance your nursing practice through ongoing learning and professional development.
Nursing Case Studies with Answers example (sample)
Below is an example of a nursing case study sample created by the Carepatron team. This sample illustrates a structured framework for documenting patient cases, outlining nursing interventions, and providing corresponding answers to guide learners through the analysis process. Feel free to download the PDF and use it as a reference when formulating your own nursing case studies.
Download this free Nursing Case Studies with Answers PDF example here
Why use Carepatron as your nursing software?
Carepatron stands out as a comprehensive and reliable solution for nursing professionals seeking efficient and streamlined workflows in their practice. With a range of features tailored to the needs of nurses and healthcare teams, Carepatron offers unparalleled support and functionality for managing various aspects of patient care.
Nurse scheduling software
One of the key advantages of Carepatron is its nurse scheduling software , which simplifies the process of creating and managing schedules for nursing staff. With intuitive scheduling tools and customizable options, nurses can easily coordinate shifts, manage availability, and ensure adequate staffing levels to meet patient needs effectively.
Telehealth platform
In addition, Carepatron offers a robust telehealth platform that facilitates remote patient monitoring, virtual consultations, and telemedicine services. This feature enables nurses to provide continuity of care beyond traditional healthcare settings, reaching patients in remote areas or those unable to attend in-person appointments.
Clinical documentation software
Furthermore, Carepatron's clinical documentation software streamlines the documentation process, allowing nurses to easily capture patient data, record assessments, and document interventions. The platform supports accurate and efficient documentation practices, ensuring compliance with regulatory standards and promoting continuity of care across healthcare settings.
Commonly asked questions
In clinical terms, a case study is a detailed examination of a patient's medical history, symptoms, diagnosis, treatment, and outcomes, typically used for educational or research purposes.
Case studies are essential in nursing as they provide real-life scenarios for nurses to apply theoretical knowledge, enhance critical thinking skills, and develop practical clinical reasoning and decision-making abilities.
Case studies in nursing education offer benefits such as promoting active learning, encouraging problem-solving skills, facilitating interdisciplinary collaboration, and fostering a deeper understanding of complex healthcare situations.
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The Effects of Climate Change
The effects of human-caused global warming are happening now, are irreversible for people alive today, and will worsen as long as humans add greenhouse gases to the atmosphere.
- We already see effects scientists predicted, such as the loss of sea ice, melting glaciers and ice sheets, sea level rise, and more intense heat waves.
- Scientists predict global temperature increases from human-made greenhouse gases will continue. Severe weather damage will also increase and intensify.
Earth Will Continue to Warm and the Effects Will Be Profound
Global climate change is not a future problem. Changes to Earth’s climate driven by increased human emissions of heat-trapping greenhouse gases are already having widespread effects on the environment: glaciers and ice sheets are shrinking, river and lake ice is breaking up earlier, plant and animal geographic ranges are shifting, and plants and trees are blooming sooner.
Effects that scientists had long predicted would result from global climate change are now occurring, such as sea ice loss, accelerated sea level rise, and longer, more intense heat waves.
The magnitude and rate of climate change and associated risks depend strongly on near-term mitigation and adaptation actions, and projected adverse impacts and related losses and damages escalate with every increment of global warming.
Intergovernmental Panel on Climate Change
Some changes (such as droughts, wildfires, and extreme rainfall) are happening faster than scientists previously assessed. In fact, according to the Intergovernmental Panel on Climate Change (IPCC) — the United Nations body established to assess the science related to climate change — modern humans have never before seen the observed changes in our global climate, and some of these changes are irreversible over the next hundreds to thousands of years.
Scientists have high confidence that global temperatures will continue to rise for many decades, mainly due to greenhouse gases produced by human activities.
The IPCC’s Sixth Assessment report, published in 2021, found that human emissions of heat-trapping gases have already warmed the climate by nearly 2 degrees Fahrenheit (1.1 degrees Celsius) since 1850-1900. 1 The global average temperature is expected to reach or exceed 1.5 degrees C (about 3 degrees F) within the next few decades. These changes will affect all regions of Earth.
The severity of effects caused by climate change will depend on the path of future human activities. More greenhouse gas emissions will lead to more climate extremes and widespread damaging effects across our planet. However, those future effects depend on the total amount of carbon dioxide we emit. So, if we can reduce emissions, we may avoid some of the worst effects.
The scientific evidence is unequivocal: climate change is a threat to human wellbeing and the health of the planet. Any further delay in concerted global action will miss the brief, rapidly closing window to secure a liveable future.
Here are some of the expected effects of global climate change on the United States, according to the Third and Fourth National Climate Assessment Reports:
Future effects of global climate change in the United States:
U.S. Sea Level Likely to Rise 1 to 6.6 Feet by 2100
Global sea level has risen about 8 inches (0.2 meters) since reliable record-keeping began in 1880. By 2100, scientists project that it will rise at least another foot (0.3 meters), but possibly as high as 6.6 feet (2 meters) in a high-emissions scenario. Sea level is rising because of added water from melting land ice and the expansion of seawater as it warms. Image credit: Creative Commons Attribution-Share Alike 4.0
Climate Changes Will Continue Through This Century and Beyond
Global climate is projected to continue warming over this century and beyond. Image credit: Khagani Hasanov, Creative Commons Attribution-Share Alike 3.0
Hurricanes Will Become Stronger and More Intense
Scientists project that hurricane-associated storm intensity and rainfall rates will increase as the climate continues to warm. Image credit: NASA
More Droughts and Heat Waves
Droughts in the Southwest and heat waves (periods of abnormally hot weather lasting days to weeks) are projected to become more intense, and cold waves less intense and less frequent. Image credit: NOAA
Longer Wildfire Season
Warming temperatures have extended and intensified wildfire season in the West, where long-term drought in the region has heightened the risk of fires. Scientists estimate that human-caused climate change has already doubled the area of forest burned in recent decades. By around 2050, the amount of land consumed by wildfires in Western states is projected to further increase by two to six times. Even in traditionally rainy regions like the Southeast, wildfires are projected to increase by about 30%.
Changes in Precipitation Patterns
Climate change is having an uneven effect on precipitation (rain and snow) in the United States, with some locations experiencing increased precipitation and flooding, while others suffer from drought. On average, more winter and spring precipitation is projected for the northern United States, and less for the Southwest, over this century. Image credit: Marvin Nauman/FEMA
Frost-Free Season (and Growing Season) will Lengthen
The length of the frost-free season, and the corresponding growing season, has been increasing since the 1980s, with the largest increases occurring in the western United States. Across the United States, the growing season is projected to continue to lengthen, which will affect ecosystems and agriculture.
Global Temperatures Will Continue to Rise
Summer of 2023 was Earth's hottest summer on record, 0.41 degrees Fahrenheit (F) (0.23 degrees Celsius (C)) warmer than any other summer in NASA’s record and 2.1 degrees F (1.2 C) warmer than the average summer between 1951 and 1980. Image credit: NASA
Arctic Is Very Likely to Become Ice-Free
Sea ice cover in the Arctic Ocean is expected to continue decreasing, and the Arctic Ocean will very likely become essentially ice-free in late summer if current projections hold. This change is expected to occur before mid-century.
U.S. Regional Effects
Climate change is bringing different types of challenges to each region of the country. Some of the current and future impacts are summarized below. These findings are from the Third 3 and Fourth 4 National Climate Assessment Reports, released by the U.S. Global Change Research Program .
- Northeast. Heat waves, heavy downpours, and sea level rise pose increasing challenges to many aspects of life in the Northeast. Infrastructure, agriculture, fisheries, and ecosystems will be increasingly compromised. Farmers can explore new crop options, but these adaptations are not cost- or risk-free. Moreover, adaptive capacity , which varies throughout the region, could be overwhelmed by a changing climate. Many states and cities are beginning to incorporate climate change into their planning.
- Northwest. Changes in the timing of peak flows in rivers and streams are reducing water supplies and worsening competing demands for water. Sea level rise, erosion, flooding, risks to infrastructure, and increasing ocean acidity pose major threats. Increasing wildfire incidence and severity, heat waves, insect outbreaks, and tree diseases are causing widespread forest die-off.
- Southeast. Sea level rise poses widespread and continuing threats to the region’s economy and environment. Extreme heat will affect health, energy, agriculture, and more. Decreased water availability will have economic and environmental impacts.
- Midwest. Extreme heat, heavy downpours, and flooding will affect infrastructure, health, agriculture, forestry, transportation, air and water quality, and more. Climate change will also worsen a range of risks to the Great Lakes.
- Southwest. Climate change has caused increased heat, drought, and insect outbreaks. In turn, these changes have made wildfires more numerous and severe. The warming climate has also caused a decline in water supplies, reduced agricultural yields, and triggered heat-related health impacts in cities. In coastal areas, flooding and erosion are additional concerns.
1. IPCC 2021, Climate Change 2021: The Physical Science Basis , the Working Group I contribution to the Sixth Assessment Report, Cambridge University Press, Cambridge, UK.
2. IPCC, 2013: Summary for Policymakers. In: Climate Change 2013: The Physical Science Basis. Contribution of Working Group I to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change [Stocker, T.F., D. Qin, G.-K. Plattner, M. Tignor, S.K. Allen, J. Boschung, A. Nauels, Y. Xia, V. Bex and P.M. Midgley (eds.)]. Cambridge University Press, Cambridge, United Kingdom and New York, NY, USA.
3. USGCRP 2014, Third Climate Assessment .
4. USGCRP 2017, Fourth Climate Assessment .
Related Resources
A Degree of Difference
So, the Earth's average temperature has increased about 2 degrees Fahrenheit during the 20th century. What's the big deal?
What’s the difference between climate change and global warming?
“Global warming” refers to the long-term warming of the planet. “Climate change” encompasses global warming, but refers to the broader range of changes that are happening to our planet, including rising sea levels; shrinking mountain glaciers; accelerating ice melt in Greenland, Antarctica and the Arctic; and shifts in flower/plant blooming times.
Is it too late to prevent climate change?
Humans have caused major climate changes to happen already, and we have set in motion more changes still. However, if we stopped emitting greenhouse gases today, the rise in global temperatures would begin to flatten within a few years. Temperatures would then plateau but remain well-elevated for many, many centuries.
Discover More Topics From NASA
Explore Earth Science
Earth Science in Action
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Facts About Earth
- Open access
- Published: 01 April 2024
Blood donation projections using hierarchical time series forecasting: the case of Zimbabwe’s national blood bank
- Coster Chideme 1 ,
- Delson Chikobvu 1 &
- Tendai Makoni 1
BMC Public Health volume 24 , Article number: 928 ( 2024 ) Cite this article
Metrics details
The discrepancy between blood supply and demand requires accurate forecasts of the blood supply at any blood bank. Accurate blood donation forecasting gives blood managers empirical evidence in blood inventory management. The study aims to model and predict blood donations in Zimbabwe using hierarchical time series. The modelling technique allows one to identify, say, a declining donor category, and in that way, the method offers feasible and targeted solutions for blood managers to work on.
The monthly blood donation data covering the period 2007 to 2018, collected from the National Blood Service Zimbabwe (NBSZ) was used. The data was disaggregated by gender and blood groups types within each gender category. The model validation involved utilising actual blood donation data from 2019 and 2020. The model's performance was evaluated through the Mean Absolute Percentage Error (MAPE), uncovering expected and notable discrepancies during the Covid-19 pandemic period only.
Blood group O had the highest monthly yield mean of 1507.85 and 1230.03 blood units for male and female donors, respectively. The top-down forecasting proportions (TDFP) under ARIMA, with a MAPE value of 11.30, was selected as the best approach and the model was then used to forecast future blood donations. The blood donation predictions for 2019 had a MAPE value of 14.80, suggesting alignment with previous years' donations. However, starting in April 2020, the Covid-19 pandemic disrupted blood collection, leading to a significant decrease in blood donation and hence a decrease in model accuracy.
Conclusions
The gradual decrease in future blood donations exhibited by the predictions calls for blood authorities in Zimbabwe to develop interventions that encourage blood donor retention and regular donations. The impact of the Covid-19 pandemic distorted the blood donation patterns such that the developed model did not capture the significant drop in blood donations during the pandemic period. Other shocks such as, a surge in global pandemics and other disasters, will inevitably affect the blood donation system. Thus, forecasting future blood collections with a high degree of accuracy requires robust mathematical models which factor in, the impact of various shocks to the system, on short notice.
Peer Review reports
Introduction
Blood transfusion requirements are on the rise globally as a result of accidents, diseases and advanced surgeries. Zimbabwe often experiences shortages in the majority blood group O during public holiday periods. This is mainly due to the high demand for clinical blood transfusion as a result of a surge in road accidents and injuries during such periods [ 1 ]. Type O blood is the most needed blood type in transfusion centres and more than 52% of Zimbabweans are in blood group O [ 2 ]. Accurate forecasts of the number of volunteer donors and blood donations help blood service managers in managing their categories of blood inventories and plan accordingly for the education and recruitment of voluntary non-remunerated blood donors and subsequent blood collection.
In the blood supply chain, future forecasting of blood supply is a critical step to ensure the adequate availability of safe blood when clinical transfusion is required. Accurate and coherent blood donation forecasting provides blood managers with empirical evidence regarding when to order blood, educate and recruit new blood donors, the estimated quantities required of each blood group to collect and potential donor categories to target.
The blood supply chain is dynamic, and as such, some studies have expressed concern over the potential reduction in blood donations emanating from multiple factors including donor demographical variations [ 3 ]. Time series analysis can be used to understand the patterns in blood donation data and help blood managers in predicting future blood donations. This information is useful for minimising volatility in blood stocks and preventing blood stockouts. Understocking blood has detrimental effects on patient safety in the healthcare system, while overstocking results in wasteful discards of outdated blood [ 4 , 5 , 6 , 7 , 8 , 9 ]. Accurate and coherent forecast of blood donations are vital as part of the decision support system for blood centre authorities as they need to know the future of blood supply when given the surge in daily blood demand [ 10 ].
The blood supply chain is dependent upon a finite number of donors. This is then aggravated by the fact that blood donation is very irregular and uncertain [ 11 ]. Blood donations/demand estimates based on employee opinions, experience, and intuition rather than quantitative models are currently used to determine both the current and future blood provisions in most blood centres globally, and especially in developing countries [ 12 ]. The unavailability or non-use of quantitative models in estimating blood donations can indeed cause volatility and uncertainty in the blood supply chain. Without these models, it can be difficult to accurately predict how much blood will be available for clinical transfusions, and this can lead to shortages or excesses of blood in certain areas. The application of quantitative prediction models in a blood bank helps to reduce errors in decision-making about the quantity of blood to be supplied and demanded [ 13 ].
With increased demand for blood and blood components against a declining voluntary blood donor pool, improving the availability and safety of the blood supply, and forecasting become vital for sustaining any blood bank to meet its core mandate. Numerous techniques have been applied in time series forecasting in general, such as autoregressive integrated moving average (ARIMA), exponential smoothing (ES), fuzzy systems (FS), artificial neural networks (ANN), logistic regression, support vector machine (SVM) and hierarchical time series forecasting. Hierarchical time series forecasting allows forecasting of time series at different levels of a hierarchical structure whilst preserving the relationships and dependencies within the hierarchy. Furthermore, the forecasts at each hierarchical level are aggregated or disaggregated to give the forecasts at higher or lower levels in the hierarchy.
The correlation between data of donor specific characteristics and blood donations can result in huge datasets of times series, which can then be classified into clusters or hierarchies. The essence of hierarchical forecasting in blood donation is derived from the fact that the blood donors can be categorised into various clusters such as gender, blood group type, and donor status. Data from the NBSZ indicates that male blood donors constitute about 54% of the donor pool and the female donors accounting for the remaining 46%. Also, the donations are classified according to the ABO donor blood group system with blood group O accounting for 54%, blood group A constitutes 24%, blood group B, 18% and blood group AB, 4%.
Hierarchical time series is effective in forecasting hierarchically organised data which can be aggregated and disaggregated at different levels [ 14 ]. In the blood supply chain, the total blood donation forecast is required at the top level of the hierarchy for inventory planning, resource allocation and other blood drive logistics. It is possible to create a hierarchical structure that captures the relationships between these different categories of donors. For example, at the highest level of the hierarchy, there may be forecasts for the overall national blood supply. At the next level down, there may be forecasts for the different gender of donors, viz: male and female. At the next level down, there may be forecasts for the different blood group types, viz: A, B, AB, and O. When these different levels based on donor characteristics are not factored in, this may result in incoherent time series forecasting, less targeting of interest groups, resulting in not being able to meet blood demand of a particular type in a given area(s).
The aim of the study is to use a hierarchical time series forecasting approach to predict blood donation patterns. By using this approach, it is possible to create more accurate and detailed forecasts for blood donations, taking into account the relationships and dependencies between different categories of donors. This can help blood banks to better manage their inventory and ensure that they have enough blood for the right group, adequate number of units in an area given at the right time to meet patient needs. To the best of our knowledge, the application of hierarchical time series in the blood supply chain problems has not been investigated, especially in the context of Zimbabwe and Africa, considering the available blood supply chain forecasting literature. Hierarchical forecasting is a very instrumental statistical technique to support decision-making in most supply chains [ 15 ], hence its application in blood donation projections is vital.
Literature review
Forecasting hierarchical time series is a relatively new to the forecasting phenomenon. Hierarchical time series forecasting has gained wider application in recent years [ 16 ]. Many phenomena in the real world, such as stock prices, weather, consumer demand, tourism demand, blood supply system, just to mention a few, can be modelled using the hierarchical time series. However, the correlation of different points of the time series makes some of the algorithms less versatile in forecasting [ 13 ]. A multivariate time-series model based on long-short-term memory (LSTM) in forecasting blood donation and demand during the Covid-19 pandemic at Tehran Blood Centre in Iran [ 17 ]. The LSTM is a recurrent neural network-based deep learning model. The study results showed that the forecasting model reduced blood shortage and wastage by 5.5% when compared to existing forecasting methods, such as the ARIMA, used the time series models in forecasting blood donation at a university medical care centre in Portugal [ 11 ]. The study developed six models, viz: ETS, Holt-Winters, autoregressive neural networks, ARIMA, double-seasonal Holt-Winters, and exponential smoothing (ES). The study concluded that trend lines of donations were better modelled by different models with different forecasting horizons. However, the ARIMA model outperformed all the other models in generating forecasts, hence the ARIMA model is part of the hierarchical forecasting approach to be adopted in this study, forecasted the supply of blood at blood centres in Taiwan using data from the Taiwan Blood Services Foundation [ 18 ]. They applied two different techniques in forecasting, viz: times series and machine learning. Under time series, they employed autoregressive (AUTOREG), ARMA, ARIMA, seasonal ARIMA (SARIMA), seasonal exponential smoothing model (ESM) and Holt-Winters. Under the machine learning algorithms, they used ANN and multiple regression. The study results showed that time series forecasting methods (seasonal ESM and ARIMA models) generated accurate predictions when compared to machine learning algorithms. Hence, this study will adopt ARIMA and ETS models, concurred that blood donation was influenced by transfusion demand [ 19 ]. The study forecasted red blood cells demand using three-time series methods, viz: ARIMA, Holt-Winters and neural-network-based method. The study results showed that a SARIMA model produced accurate forecasts over a shorter time horizon of one year. The ES outperformed the other methods over longer time horizons stated that managing blood supply and demand was difficult in most blood banks globally [ 20 ]. They highlighted the need for accurate and reliable blood supply and demand forecasting models. They conducted a study at the National Health Service Blood and Transplant in England using four different time series methods which were selected using the minimum mean squared error (MMSE) and weighted least squares error (WLSE). The methods yielded similar results.
A study concluded that there is no single statistical forecasting technique that is universally better and applicable at all times [ 21 ]. The authors conducted blood demand forecasting in Finland and the Netherlands. They applied moving averages (MA), ETS, ARIMA, autoregressive neural networks (NNAR), seasonal naïve (SNAIVE), method averaging (AVG), seasonal trend decomposition methods (STL and STLF), dynamic seasonal method (TBATS), dynamic regression (DYNREG), multilayer perceptrons (MLP) and extreme learning machine (ELM). The model performances were compared using mean absolute percentage errors (MAPEs). The results show that DYNREG performed better than the other approaches in generating forecasts emphasised the importance of accurate predictions in blood provision [ 22 ]. Their study at Shirazi blood centre in Iran applied ARIMA, ANN and hybrid approaches in forecasting different blood groups demand. Mean Square Error (MSE) and Mean Absolute Error (MAE) were used to compare and validate the fitted models. The results showed that ARIMA model outperformed the other models in the forecasting accuracy [ 23 ] forecasted the demand in the blood supply chain using platelets at Canadian Blood Services. The study used five different forecasting methods, viz: ARIMA, Prophet, lasso regression (least absolute shrinkage and selection operator), random forest and LSTM (Long Short-Term Memory) networks. The results showed that with limited data, multivariate models performed better than univariate models. However, with adequate data, ARIMA models produced similar results to multivariate methods. The current study uses both the ARIMA and the ETS under the hierarchical forecasting approach models.
Material and methods
Secondary data used in this study corresponds to the grand total of blood collections (blood units) from the five regional blood centres in Zimbabwe based on specific donor characteristics (gender and blood group). This information is useful for developing a hierarchical structure for forecasting blood donations, as it enables the researchers to consider the relationships and dependencies between different categories of blood group types and blood donors. The data was collected from the NBSZ Laboratory Information Management System (LIMS) and annual reports which are freely available on the link https://nbsz.co.zw/ , where certain blood donations information is captured in aggregate form. Monthly blood donation data covering the period 2007 to 2018 was used in the forecasting, giving a total of 144 monthly observations.
Using the approach [ 14 ], a tree diagram of blood donations comprising a two-level hierarchical structure is presented in Fig. 1 . The tree diagram is constructed based on the disaggregated blood data that was categorised according to two variables: gender (Male and Female) and blood group type (A, B, AB and O). Level 0 represents the total blood donations in Zimbabwe. Level 1 denotes the first disaggregation by gender (Male (M) and Female (F)). Level 2 denotes further disaggregation by blood groups according to the ABO blood group system (A, B, AB and O).
Blood donations hierarchical structure based on donor gender and blood group type
The R-package HTS is used to generate the forecasts using the bottom-up, top-down and the optimal combination methods. The EST and ARIMA methods are used to generate the forecasts.
Hierarchical forecasting techniques
(Fig. 1 . Blood donations hierarchical structure based on donor gender and blood group type).
According to Fig. 1 , level 0 gives completely aggregated blood donations (Total blood donations) denoted by \({Y}_{TB,t}\) where \(t=1, 2, 3, . . . , 144\) and are obtained by adding all the series at level 1 or level 2. Level 1 represents data disaggregated according to gender (male and female). Level 1 and level 2 series can be denoted by \({Y}_{i,t}\) , where \(i\) denotes the node in the hierarchical tree diagram. The data consists of 144 monthly observations (t = 1, 2, …, 144). Forecasts for each level were estimated using the bottom-up, top-down and optimal combination approaches. The approach with a lower accuracy measure estimated by MAPE was used to generate forecasts for the blood centre.
Let \({{\varvec{Y}}}_{t}\) and \({{\varvec{S}}}_{11X8}\) be the vector of the blood data and a summing matrix storing the hierarchical structure shown in Fig. 1 respectively.
Making use of the summing matrix ( S ), Eq. 1 can be written as
The bottom-up method
The bottom-up approach involves forecasting individually for each series at the lowest levels of the hierarchy and then aggregates the forecasts upwards to generate forecasts for higher levels. The method is based on forecasting the individual blood donations from the blood group type A, B, AB and O first. Total number of blood donations for each gender can be calculated by summing up the forecasted donations made by individuals of all blood groups. Then, by summing up the donations made by each gender, one can determine the total number of blood donations for the blood bank. In other words, the approach is concerned with producing individual base forecasts at the lower level of the hierarchy and combining the forecasts upwards through \({\varvec{S}}\) . Thus, the approach starts by producing h -step-ahead forecasts for individual bottom level time series ( \(n = 8\) ):
\({\widehat{Y}}_{AM,h},\) \({\widehat{Y}}_{BM,h,}\) \({\widehat{Y}}_{ABM,h},\) \({\widehat{Y}}_{OM,h},\) \({\widehat{Y}}_{AF,h},\) \({\widehat{Y}}_{BF,h,}\) \({\widehat{Y}}_{ABF,h},\) and \({\widehat{Y}}_{OF,h}\)
These forecasts are aggregated to get the h -step-ahead forecasts for the higher level (level 1). Level 1 h-step-ahead forecasts ( \({\widetilde{Y}}_{AM,h}, {\text{and}} {\widetilde{Y}}_{BF,h}\) ) are given by
The summing matrix ( \({\varvec{S}})\) will combine the h -step-ahead forecasts up the hierarchical structure. For the bottom-up approach, the forecasts are combined using the formula:
where \(k=0, 1, 2.\)
The advantage of the bottom-up approach is that no information is lost since forecasts are generated at the lowest or base level of the hierarchy. The major setbacks of the method are that, it performs poorly on highly aggregated data and it does not take into account the correlations between the series. Also, too much data points in the base level of the hierarchy requires more runtime to generate forecasts. The bottom-up method is not effective in the case of complex and multi-layered hierarchies [ 24 ]. The time series at the lowest levels often have little structure and are therefore difficult to forecast and this can result in forecasting errors which can be aggregated over numerous upper hierarchies.
The top-down method
This method forecast the highest level of the hierarchy first and then split up the forecast to generate estimates for the lower levels through the use of some proportions or factors. These proportions include average historical proportions, proportions of the historical averages and forecast proportions [ 16 , 25 ]. Historical data is used in the calculation of the proportions and the approach has the ability to yield reliable forecasts for the aggregate levels [ 26 ]. The average historical proportions formula is:
where \(i=\mathrm{1,2}, \dots , {m}_{k}.\) According to [ 26 ], every proportion reveals the average of the historical proportions of the bottom level series over time relative to the aggregated series ( \({Y}_{t})\) for \(t=1, 2, 3, . . . , N \left(N=144\right).\) Using one of the nodes in Fig. 1 and the bottom level series \({Y}_{OF,t}\) as an example, we can have;
where \({\widehat{S}}_{Total,t}={\widehat{Y}}_{M,t}+ {\widehat{Y}}_{F,t}\) and \({\widehat{S}}_{F,t}={\widehat{y}}_{AF,t}+{\widehat{y}}_{BF,t}+{\widehat{y}}_{ABF,t}+{\widehat{y}}_{OF,t}\)
Advantages of the method is that it provides reliable forecasts for higher levels in the hierarchy and is useful when the lower-level series are noisy and difficult to forecast. The major setback of the method is that there is general loss of information resulting in less accurate forecast being generated at base or lower levels of the hierarchy [ 27 ].
Optimal combination method
Handyman RJ et al. [ 14 ] proposed an optimal combination approach for forecasting that utilises all the available information and combinations in a hierarchy. This approach involves making independent forecasts at all levels, which are then reconciled using a linear regression model. The resulting forecasts are coherent and based on weights obtained by solving a system of equations that respect the relationships between the different levels of the hierarchy. This method can estimate the unknown future expectation values of the lowest level of the dataset, K. Given a vector of the unknown means ( \({{\varvec{\beta}}}_{n}(h))\) , thus,
Since \({{\varvec{Y}}}_{t}\) represents the vector of all observations at time t while and \({{\varvec{Y}}}_{k,n+h}\) represents the vector of observations in the bottom level K . The base forecasts ( \({\widehat{{\varvec{Y}}}}_{n}\left(h\right))\) are presented in a regression format to give:
where \({{\varvec{\varepsilon}}}_{h}\) denotes a white noise process with covariance matrix \(\sum h\) which is difficult to find in large hierarchies [ 26 ]. However, [ 14 ] proposed estimating the white noise process by the forecast error in the bottom level, thus, \({{\varvec{\varepsilon}}}_{h}\approx {\varvec{S}}{{\varvec{\varepsilon}}}_{k,h}\) . With this hypothesis, errors satisfy the same aggregation constraint as the dataset, resulting in
The optimal combination approach has a key advantage in that it is capable of producing highly accurate forecasts in comparison to both top-down and bottom-up methods. Additionally, it allows for unbiased forecasts to be generated at all levels while minimising the loss of information. This approach also enables the utilisation of diverse independent forecasting methods, such as ARIMA and ETS, at each level to generate the most accurate forecasts possible. However, one significant drawback of the optimal combination approach is that it can become very complex and computationally intensive when dealing with numerous time series.
Forecasting individual series
The ETS and ARIMA are the common methods used. The general ARIMA model can be expressed as
where \(\Phi {\prime}s\) and \(\mathrm{\Theta {\prime}}{\text{s}}\) are model parameters.
\({Y}_{t}\) – is the stationary series,
\({\Phi }_{p}\) – is the coefficient of the p th AR term, where p is the order of the AR term,
\({\Theta }_{q}\) – is the coefficient of the q th MA term, where q is the order of the MA term,
\({a}_{t}\) —is the error term.
The general forms of the Holt-Winters with permanent constant, linear trend and multiplicative seasonal variations are:
where the smoothing parameters ( \(\gamma ,\) \(\alpha\) and \(\beta\) ) take values between 0 and 1. The smoothed series and seasonality period is denoted \({\widetilde{Y}}_{t}\) and \(s\) respectively. Both the ETS and the ARIMA default algorithms are incorporated in the R forecast package HTS. The mean absolute percentage error (MAPE) was used to assess forecasting performance of the models. The MAPE formula is:
where \({y}_{t}\) are the actual blood donation values observed, \({\widehat{y}}_{t}\) are predicted blood donation values by the model and \(m\) is the prediction period.
Model validation
The disruptions caused by the Covid-19 pandemic altered blood donation patterns, complicating the forecasting of future blood donations for this specific period of the pandemic. The model validation involved utilising actual blood donation data from January 2019 to December 2020. The model's performance was evaluated through the Mean Absolute Percentage Error (MAPE) suggesting alignment with previous years' donations during the pre-pandemic period, however there MAPE confirmed notable discrepancies between forecasts and observed values during the period of the Covid-19 pandemic.
Data and descriptive statistics
Table 1 gives information on the structure of the hierarchy as depicted in Fig. 1 .
The descriptive statistics of the data are shown in Table 2 .
Monthly mean blood donations for blood type A were 725.02 and 591.47 for males and females, respectively. Blood group O had the highest monthly mean as expected, 1507.85 and 1230.03 for male and female donors respectively. Blood group AB had the least mean donations 115.09 and 94.69 for male and female donors respectively. The negative kurtosis (platykurtic) shows that more donation data are located near the mean and less values are located on the tails thus no cases of extreme values or outliers.
The characteristics of the disaggregated blood donations are depicted in Fig. 2 .
Time series plots based on donor gender and blood group type from 2007 – 2018
In Fig. 2 , the total blood donations at level 0 exhibit some seasonality. There are no significant variations in the blood donation patterns even though there were some periods of declines in blood donations. At level 1, the male donations (M) surpassed their female counterparts (F). It is evident from Fig. 2 that blood group O donations (OM and OF) have the highest volumes, followed by blood group A and blood group AB being the least. At level 2, male blood group O had a maximum of 2888 units, female blood group O had a maximum of 2269 units and female blood group AB had the least maximum of 175 units. Such insights help blood centre authorities to plan for blood donor education and recruitment scheduling, fixed and mobile drives, blood collection and also meeting clinical blood transfusion needs.
Forecasting accuracy evaluation
The MAPE accuracy measure was used to assess the forecasting performance of the models. An out-of-sample forecasting accuracy measure is done. Table 3 presents accuracy done for both the ETS and ARIMA as forecasting methods.
The average accuracy measures from each model are under the row named “Average”. It is shown in Table 3 that the TDFP approach produces small MAPE values under the ARIMA forecasting method forecasting method. The TDFP under ARIMA with MAPE error of 11.30 is the best and is used to forecast future blood quantities. Table 4 and Fig. 3 show out-of-sample forecasted future values for 60 months and their graphical display.
Blood donation forecasts from 2019 – 2023 using TDFP under ARIMA
From Fig. 3 , future blood donations forecasts are indicated by the dashed/dotted line(s) while the historical data are represented by solid line(s). At level 1, future projections show that, male donations are higher than female donations. Similarly, at level 2, the projected donations for blood group O for males (OM) are higher than for their female (OF) counterparts. It is evident from all the three-levels in Fig. 3 that there could be a steady to slight decline in future blood donations for all the donor categories based on the projections. This can be attributed to a real problem of a continuous decline in numbers of regular voluntary blood donors in most blood centres. Low blood donations for blood group AB are projected to continue in the short to long term periods. This calls for the development of sound policies and interventions in blood donor and blood management (Table 5 ).
The blood donation predictions for 2019 had a MAPE value of 14.80, suggesting alignment with previous years' donations. However, starting in April 2020, the Covid-19 pandemic disrupted blood collection, leading to a significant decrease in blood donation and hence a decrease in model accuracy, and this is then reflected in a high MAPE value of 84.06.
The aim of this study was to explore blood donation forecasting technique that could generate accurate and coherent predictions. The blood donation data in Zimbabwe recorded by the NBSZ was categorised according to donor specific characteristics. These categories gave rise to hierarchical time series forecasting. The forecasts from the approach suggest the need for effective donor education and recruitment drives targeting blood group O donors since they are universal blood donors and blood type O is always on high demand. These methods are strongly recommended as they give feasible solutions. They capture blood donor data dynamics, produce precise and sensible forecasts.
Previous studies have attributed patterns in blood supply to socio-demographic characteristics [ 28 , 29 , 30 ]. These donor specific characteristics give rise to clusters warranting the application of hierarchical forecasting. Therefore, there is need to make blood donation projections based on blood donor socio-demographic characteristics.
A study by [ 31 ] projected future blood donors in Birjand City, Iran using decision trees. Their models yielded poor performance based on the measures of accuracy. They concluded that the trees had numerous disaggregation of the data leading to data overfitting. Results from the current study indicated that the data disaggregation helped in generating accurate and coherent forecasts.
A time series analysis by aggregating blood donation frequency by month was conducted by [ 32 ]. The study results showed a stable blood supply for most months except in June and September periods which coincide with religious festivals in Saudi Arabia. The current study results showed seasonality in the donation patterns. The seasonality is linked to public holiday months and school holidays in Zimbabwe during the months of April, August and December each year.
Forecasting blood donation based on blood group prevalence is vital in managing blood supply at a blood bank [ 33 ]. Keeping track of dynamic changes in the donation prevalence of different blood groups is important since the distribution of the blood groups varies with time [ 34 , 35 ]. Also, [ 36 ] concluded that blood donors with blood group O had higher frequency of blood donations and a lesser risk of lapsing, leading to the need for high blood donation volumes compared to other blood groups.
The current study shows that blood donations from blood group O donors have the highest volumes of donations compared to the other blood groups. This can be associated with the fact that the proportion of blood group O is highest in the donor population in Zimbabwe (52%). At the same time, blood group O donors are referred to as universal donors because blood type O can be transfused to blood A and B patients in emergencies where there was no time for matching blood types. However, it is current best practice to transfuse group-specific blood. Such insights help blood centre authorities to plan for blood donor education and recruitment, schedule blood drives and blood collections and also meeting clinical blood transfusion needs.
The results from the blood donation projections by gender concurs with other researchers where male donations are consistently higher than their female donations [ 37 , 38 , 39 ]. The current study also shows similar trends where male blood donors had higher mean blood donations compared to the female donors. Males have a higher frequency of donations as they are allowed, through regulation, to donate blood after every 12 weeks compared to 16 weeks interval for the female donors. Other researchers have attributed the lower donation volumes of female donors to high donor lapsing compared to male donors [ 36 , 40 ].
Women generally donate blood less than men due to deferrals as a result of iron depletion through menstrual blood loss.
The blood donation projections from the study have some clinical implications. Some previous studies have shown that the survival rate of patients transfused with blood from male donors was higher compared to female donors [ 41 ]. Therefore, the higher proportion of male donors in the pool is vital in clinical blood transfusion. Also, Zimbabwe often experiences shortages in blood group type O. Therefore, the higher proportion of blood group O donors in the projections will help blood authorities in rationalising blood donor education and recruitment to minimise blood shortfalls.
Blood collections trend took a down turn from April 2020 as the government of Zimbabwe introduced Covid-19 lockdown restrictions to reduce the spread of the pandemic. These measures rendered most blood collection sites inaccessible as movement of people was restricted. The NBSZ had to rely on community based and walk in blood donors and this resulted in a 40% decrease in units of blood collected compared to 2019. The same negative impact of the Covid-19 pandemic can be observed from 2021 up to June 2022. This means that alternative models could be developed in future studies to analyse the impact of pandemics in forecasting blood donations. A time series with intervention model would be an ideal alternative candidate. The model focuses on the shock or pulse that results after say, a pandemic.
The discrepancy between blood supply and demand and the perishability of blood and blood components can be alleviated somewhat through accurate forecasts of the blood supply at any blood bank. Such accurate and coherent forecasts help in safeguarding the risks of understocking and overstocking the scarce and perishable resource, blood. Thus, accurate statistical forecasting methods play a significant role in future blood donation projections. The top-down, bottom-up and optimal combination approaches were adopted in the study with each approach having its own merits and demerits. The EST and ARIMA methods were used to generate the forecasts. The TDFP under ARIMA with the smallest MAPE was considered to be the best and was then used to forecast future blood donations.
Future blood forecasts indicated a slight decrease in total blood donations. This suggests the need for blood centre authorities to develop sound blood donor management interventions. Such interventions include an integrated strategy of the entire blood safety value chain, including donor education, targeted recruitment and retention, scheduled fixed and mobile blood donation drives, safe blood collection and donor care and adequate resource allocation.
Study results showed that blood donations from blood group O donors have the highest volumes of donations compared to the other blood groups. Also, blood donations by the male gender are higher than donations by their female counterparts. These trends are attributed to the higher proportions of donors in these categories.
This study will contribute to the board of knowledge on the adoption of coherent and accurate hierarchical forecasting methods in ensuring an adequate and safe blood supply chain in a low resource setting like Zimbabwe.
This study has potential limits. The lack of prior research studies on the topic limited the scope of the current study. The impact of the Covid-19 pandemic distorted the blood donation patterns such that the developed model did not capture the significant drop in blood donations during the pandemic period. Other shocks such as, a surge in global pandemics and other disasters, will inevitably affect the blood donation system. This means that future blood supplies remain under threat. Thus forecasting future blood collections with a high degree of accuracy requires robust mathematical models which factor in the impact of various shocks to the system on short notice. Door to door blood donation drives are not out of the question in such instances .
Availability of data and materials
The data that support the findings of this study are available from the corresponding author and the National Blood Service Zimbabwe upon reasonable request.
Abbreviations
National Blood Service Zimbabwe
Error-Trend-Seasonality
Autoregressive Integrated Moving Average
Mean Absolute Percentage Error
Top-Down Forecasting Proportions
Fuzzy Systems
Artificial Neural Networks
Support Vector Machine
Hierarchical Time Series
Mean Square Error
Mean Absolute Error
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The authors would like to extend their sincere gratitude to the NBSZ staff for their critical role in facilitating access to the data used in this study.
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Chideme, C., Chikobvu, D. & Makoni, T. Blood donation projections using hierarchical time series forecasting: the case of Zimbabwe’s national blood bank. BMC Public Health 24 , 928 (2024). https://doi.org/10.1186/s12889-024-18185-7
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Effects of sleep-disordered breathing on serum lipid levels in children:a case control study
- Lei Lei 1 ,
- XiaoYun Zhang 1 ,
- Binbin Wang 1 ,
- Fei Lei 2 ,
- Xiaoru Sun 1 ,
- Yu Zhao 1 ,
- Ping Zhu 4 &
- Jian Zou 1
BMC Pediatrics volume 24 , Article number: 220 ( 2024 ) Cite this article
Metrics details
Sleep-disordered breathing (SDB) during childhood is common and includes a range of breathing abnormalities that range from primary snoring (PS) to obstructive sleep apnea syndrome (OSAS).Studies have shown that not only OSAS, but also PS, which is originally considered harmless, could cause cardiovascular, cognitive, behavioral, and psychosocial problems. Many researches are focused on the relation of OSA and serum lipid levels. However, little studies are focused on PS and serum lipid levels in children.We evaluated whether serum lipid (total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C)) concentrations were associated with specific components of SDB, including indices of oxygen reduction index, lowest oxygen saturation, mean oxygen saturation. And we explored whether serum lipid levels were associated with different degree sleep disordered (PS and OSA group) and obese.
This was a cross-sectional study. Children who were complained by their guardians with habitual snoring and(or) mouth breathing were collected in the SDB group. Normal children without sleep problem were matched in the control group. Subjects in the SDB group underwent polysomnography. The serum lipid profiles of all the children included TC, TG, HDL-C and LDL-C concentrations were measured by appropriate enzymatic assays.
A total of 241 with Apnea/Hypopnea Index ≥ 5 (AHI) were assigned to the OSAS group and the remaining 155 with normal AHI were assigned to the PS group. The values of TC, TG, LDL-C and LDL/HDL were significantly higher in the OSAS group than in the PS group, and the values in the PS group were significantly higher than the control group. Multiple regression analysis revealed serum TG only correlated negatively with lowest oxygen saturation. Body mass index-z score has a positive effect on TG in all the 1310 children ( P = 0.031) and in SDB 396 children( P = 0.012). The level of serum TG in obese group was significantly higher than that in non-obese group.
Conclusions
SDB had a very obvious effect on blood lipids, whereas PS without apnea and hypoxia. Obese only affects the aggregation of TG.
Trial registration
ChiCTR1900026807(2019.10.23).
Peer Review reports
Sleep-disordered breathing (SDB) during childhood is common and includes a range of breathing abnormalities that range from primary snoring (PS) to obstructive sleep apnea syndrome (OSAS).PS is also referred to as simple or non-apneic snoring, and is regarded as the mildest form of SDB that does not have severe medical consequences. The most severe manifestation of SDB is OSAS, which is characterized by repeated episodes of upper-airway obstruction during sleep [ 1 ].
SDB is increasingly recognized as contributing to a substantive public health burden in both adults and children. Studies in pediatric populations have shown an association between SDB and alterations in metabolic syndrome, systemic blood pressure levels, echocardiographic findings and insulin resistance [ 2 , 3 , 4 ].These alterations seem to occur primarily in children with moderate to severe OSAS. Studies over the years have shown that not only OSAS, but also PS, which was originally considered harmless, can cause cardiovascular, cognitive, behavioral, and psychosocial problems [ 5 , 6 ].Research on SDB, particularly in relation to PS and serum lipid levels in children, is sparse.
In this report, we reported the difference in serum lipid levels between normal children and children with SDB. We also quantified the association between serum lipid level and of children who had undergone standardized assessment of SDB by PSG. Using the AHI score, children with SDB were divided into the PS and OSA group. We addressed the hypothesis that serum lipid level was more pronounced among children with SDB than in those without SDB. In addition, we evaluated whether the association between serum lipid and SDB was independent of sex, age and course whether serum lipid was associated with specific components of SDB, including indices of oxygen reduction index, lowest oxygen saturation, mean oxygen saturation. Finally, we explored whether individual measures of serum lipid were associated with SDB independently of obese (Body mass index-z score, BMI-z score).
Subjects and physical assessment
The cross-sectional study: between December 2019 and December 2022, children who were complained by their guardians with SDB (habitual snoring and(or) mouth breathing more than 6 months) were collected in the SDB group. Normal children without snoring and mouths breathing at the same time were matched in the control group. Children were excluded from the study if they had an intercurrent upper respiratory tract infection or systemic infection within 4 weeks of recruitment, a history of tonsillectomy and(or) adenoidectomy, neuromuscular disease, craniofacial syndromes, cerebral palsy, sickle cell disease, mucopolysaccharide storage disease, immunodeficiency and mental or physical impairment.
The weight and standing height of the subjects were measured with a calibrated weighing scale and stadiometer according to standard anthropometric methods. Body mass index(BMI) was calculated as weight/height 2 (kg/m 2 ), and the z -score was derived using CDC reference data [ 7 ]. Children were defined as obese if their BMI -z score was greater than 1.645 [ 8 ], relative to age and gender.
Polysomnography
Subjects in the SDB group underwent polysomnography, and performed using with an ambulatory polygraphic device. Obstructive apnea was defined as the absence of oronasal airflow for at least 2 breaths during. Central apnea was defined as the absence of oronasal airflow for at least 2 breaths during associated with an absence of inspiratory effort. Hypopnea was defined as at least a 50% reduction in oronasal airflow for at least 2 breaths during associated with at least a 3% decrease in oxygen saturation. The AHI was calculated as the mean number of apneas and hypopneas per hour of sleep. The obstructive and central apnea indexes were calculated as the mean number of obstructive and central apneas per hour of sleep, respectively. Subjects with an AHI score of > 5 score were designated as normal. AHI, oxygen reduction index (ORI), lowest oxygen saturation(L-SpO2), and mean oxygen saturation(M-SpO2) were recorded.
Serum lipid measurement
Venous blood samples of experimental group were collected in the overnight fasting state after polysomnography. Blood samples of control group were collected on the morning of physical examination day after an overnight fast of at least 8 h. The lipid profile included total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) concentrations, which were measured by appropriate enzymatic assays.
The study was approved by the Biomedical Research Ethics Committee of the West China Hospital of Sichuan University. Written informed consent was obtained from each patient before the study.
Statistical analysis
Continuous data are expressed as mean ± SD. Continuous data between the groups were compared using the unpaired t test or the Mann-Whitney U test. Categorical data between the groups were compared using the Fisher exact test or the χ2 test. Spearman rank correlations were used to examine correlations between the continuous variables. Univariate and multiple regression analyses were performed to determine variables associated with TC, LDL-C, HDL-C and LDL-C/HDL-C. Because body mass index z-score (BMI-z), TG, AHI, ORI, L-SpO2, M-SpO2 were not normally distributed, logarithmically transformed values of these variables were used in the analyses. Multiple regression analysis was performed using explanatory variables that showed P < 0.05 on univariate analysis. A P < 0.05 was considered to be statistically significant. All analyses were performed using SPSS software (version 22.0; IBM SPSS, Armonk, NY, USA).
Patient characteristics and overnight polysomnographic findings
A total of 1310 children were concluded in the study. In the SDB group, a total of 396 subjects with breathing problems having PSG results were recorded. And 241 with AHI>5 were assigned to the OSAS group and the remaining 155 with AHI ≤ 5 were assigned to the PS group. Nine hundred and fourteen normal children without sleeping problems during the same period were collected in the control group. Patient characteristics and overnight polysomnographic results were shown in Table 1 .
From the Table 1 , boys and obese children were significantly more in OSA group than in PS group, and more common in the PS group than in the control group. No statistical difference was shown in age among the three groups. Course of disease between PS and OSAS groups have no difference.
SDB leading to abnormal serum lipid parameters
SDB group were divided into the OSAS group and the PS group. From Table 2 , we could see that the values of TC, TG, LDL-C and LDL/HDL were significantly higher in the OSAS group than in the PS group, and the values in the PS group were significantly higher than the control group. While the HDL-C in the OSAS group was significantly lower than that in the PS group, and this in the PS group was significantly lower than that in the normal group.
Multiple regression analysis revealed that after adjusting age, gender, course of disease and BMI-z score, serum TG only correlated negatively with L-SpO2. Except that the lowest oxygen saturation had negatively effect on TG, night oxygen saturation (oxygen desaturation index, L-SpO2, M-SpO2) have no effects on other blood lipid parameters (TC, LDL-C, HDL-C and LDL-C/HDL-C). (Table 3 )
Obesity leads to abnormal serum TG metabolism
We adjusted for factors such as age, course of disease and gender, and found that there was still a close relationship between BMI-Z and TG in all children( N = 1310) and SDB children( n = 396). BMI-z score has a positive effect on TG in all the 1310 children ( P = 0.031) and in SDB 396 children( P < 0.001).
We divided all the subjects and SDB groups into obese and non-obese groups. The LDLC/HDLC of obese children was significantly higher than that of non-obese children of SDB children. The HDLC of obese children was significantly lower than that of non-obese children of SDB children. The level of serum TG in obese group was significantly higher than that in non-obese group, regardless of whether it was the entire study population or children with SDB (Table 4 ). TC, LDL-C and LDL-C/HDL-C in SDB group was much higher than that in the control group (Table 5 ).
The main findings of the present study were as follows: (1) serum LDL-C, TG, TC and LDL-C/HDL-C were much higher in OSA and PS group than control group;(2) serum HDL-C were much lower in OSA and PS group than control group;(3) multiple regression analysis showed that nocturnal oxygen saturation (L-SpO2, M-SpO2, ORI) and was not associated with TG, LDL-C, HDL-C, LDL-C/HDL-C expect TG;(4) serum TG correlated negatively with L-SpO2 and positively with BMI-z and obesity.
Sleep disturbance in children can cause dyslipidemia, which has been confirmed in many previous studies [ 9 ]. Redline et al.studied a group of teens and showed that adolescents with sleep respiratory disorders have seven times more chance of having metabolic alterations than adolescents with no sleep disorders [ 3 ]. We found that children with sleep disorder had worse blood lipid indicators than children without sleep disorder. Even in the PS group, which is considered as harmless [ 5 ], it is also found that there is obvious blood lipid abnormality compared with the normal group. The first interesting finding of Lorenzo Loffredo s study is that endothelial dysfunction, high oxidative stress and NOX 2 activation characterized not only in children with serious SDB, such as those with OSA, but also in children with PS [ 10 ]. In our three subgroups of OSAS group, serum lipid indicators were not related to the degree of AHI. According to the above analysis and our results, children with PS do not experience intermittent hypoxia. Therefore, we speculate that there may be other important reasons but L-SpO2 for abnormal blood lipid indicators in children caused by SDB. In fact, the review study of Sun also found the pathogenetic link of SDB with dyslipidemia remains obscure [ 11 ]. It is also possible that the reason why SDB causes lipid metabolism changes in children is may not hypoxia, but a combination of many reasons like abnormal sleep structure and shorter sleep during time leading to the change of endothelial dysfunction, high oxidative stress, NOX2 activation and other metabolic mechanism. With regard to cross-sectional findings, one study reported that longer sleep duration as measured objectively with actigraphy had a beneficial effect on overall lipid metabolism in a community cohort of children aged 4–10 years [ 10 ]. Shorter sleep duration, especially in the presence of irregular sleep patterns, was associated with higher plasma fasting insulin, low-density lipoprotein cholesterol (LDL-C), and C-reactive protein concentrations [ 12 ]. Fatma Kubra Sayin, noted a U-shape association between sleep duration and metabolic risk factors, with decreased HDL-C and decreased LDL-C and TG at lower sleep durations [ 12 ]. It is possible that the short sleep may lead to the dysregulation of adipokine secretion and is thought to be the key events in promoting both systemic metabolic dysfunction and cardiovascular disease. The change of sleep structure and the shortening of sleep duration can change many factors related to blood lipid regulation, such as leptin, adiponectin, FGF, RBP4 and so on [ 13 ]. Lipid metabolism is regulated by the circadian system, and the expression of enzymes involved in lipid metabolism is directly controlled by the circadian clock genes [ 14 ]. We speculated the following explanations for the positive association between the severity of SDB and LDL-C, HDL-C and LDL/HDL. And in the none-obese group we also found the abnormal TC, HDL-C and LDL/HDL have relation with SDB. Chronic sympathetic nervous activation caused by SDB even PS could increase the synthesis of very low-density lipoprotein in the liver and suppress the catabolism of LDL in the liver by stimulating α1-receptors, leading to a decrease in serum HDL-C and an increase in serum LDL-C and thereby an increase in LDL-C/HDL-C [ 9 ].
In the present study, L-SpO2 was independently associated with TG. Hepatic steatosis reversibly decreases viability of hepatocytes after hypoxia and reoxygenation in vitro [ 15 ]. It is hypothesized that in obesity, deregulation of inflammatory adipocytes is a response to the hypoxia that develops in adipocytes that are distant from the vasculature as adipose tissue expands; hypoxia directs the inflammatory response to adipose tissue, which includes new formation of veins [ 16 ]. This response to hypoxia is mediated by the transcription factor HIF-1a, the activity of which is now considered to indicate hypoxia in adipose tissue. Therefore, hypoxia may be one of the mechanisms leading to abnormal TG and obese [ 17 ]. In addition, sleep curtailment is associated with hormonal changes including increased cortisol and ghrelin levels, sympathovagal responses and reduced leptin [ 18 ]. Persistent insulin resistance or the presence of SDB somehow triggers weight gain. It is generally found that sleep and obesity are important factors affecting serum lipid metabolism in children. Li found obese children have significantly lower circulating plasma adiponectin and higher leptin levels than their nonobese counterparts, irrespective of their OSA status [ 18 ]. The BMI-z but not OSA was an independent predictor for both adiponectin and leptin. It is common knowledge that TG obese children increase. The study of Verhulst,et al. in subjects who were overweight and obese showed that the severity of SDB was independently correlated with a few factors associated with metabolic dysregulation [ 19 ]. Obesity is also a strong risk factor for adult SDB. Although data in children are inconclusive, obesity has been described as a risk factor for snoring or SDB in samples of older children and adolescents [ 20 ]. Our data are consistent with this and underscore the importance of overweight as an SDB risk factor in adolescents.
We observed that male gender and short sleep duration were associated with obesity. Although gender is a non-modifiable traditional cardiovascular risk factor, this underscores the identification of male subjects for more detailed evaluation and education on healthy sleep habits [ 21 ].
In aggregate, these findings point to SDB, as a contributing cause of dyslipidemia in SDB, and suggest the need for further research aimed both at elucidating the potential causal pathways that may link SDB and metabolic dysfunction, and whether treatment of SDB improves metabolic dysfunction in children.
SDB has a very obvious effect on blood lipids, whereas PS without apnea and hypoxia at night also has an adverse impact on children’s blood lipids metabolism. L-SpO2 maybe only affect TG, but have no significant impact on TC, HDL-C, LDL-C and LDL/HDL. Obese (BMI-Z) only affects the aggregation of TG and does not significantly affect other blood lipid indicators. Our data may provide some public health information and provide new insights into the relationships between lifestyle habit and health. These form the rationale for the development of interventional strategies and educational programs to promote healthy sleep habits in the young population.
We did not have PSG results of control group for comparison. Because it is difficult to subject asymptomatic children (control group) to an overnight sleep study. Through epidemiological and clinical research, we can analyze the relationship between children’s dyslipidemia and sleep, but as for the specific pathogenic factors and the close degree of correlation, we need to conduct genetic studies and analysis. Further studies are needed to investigate the pathogenetic mechanisms in exploring the causal relationship between sleep, obesity and lipid metabolism.
Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
Abbreviations
- Sleep-disordered breathing
- Primary snoring
- Obstructive sleep apnea syndrome
Total cholesterol, TG:triglyceride
High-density lipoprotein cholesterol
Low-density lipoprotein cholesterol
Lowest oxygen saturation
Mean oxygen saturation
Body mass index
Centers for Disease Control
Apnea/Hypopnea Index
Oxygen reduction index
Lowest oxygen saturation, M-SpO2:mean oxygen saturation
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Acknowledgements
We are deeply grateful to every guardian and children who were agree to participate in this study. Their joint efforts help us to get those results, and those results maybe guide the future attention to children’s sleep problems and metabolic disease.
This research was supported by the 1·3·5 project for disciplines of excellence–Clinical Research Fund, West China Hospital.
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Department of Otorhinolaryngology, Head&Neck Surgery, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
Lei Lei, XiaoYun Zhang, Binbin Wang, Xiaoru Sun, Yu Zhao & Jian Zou
Department of Sleep Medical Center, West China Hospital, West China Medical School, Sichuan University, Sichuan, China
West China Medical School, Sichuan University, Sichuan, China
Department of Clinical Research Management, West China Hospital, Sichuan University, Sichuan, China
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Contributions
Lei Lei (First Author): Conceptualization, Methodology, Funding Acquisition, Software, Investigation, Writing-Original Draft; Xiaoyun Zhang: Data Curation, Investigation, Software; Binbin Wang: Data Curation, Investigation; Fei Lei: Perform sleep breathing monitoring for Children; Li Dai: Collect blood samples for patients;Xiaoru Sun: Writing-Review & Editing; Yu Zhao: Validation, Resources, Supervision;Ping Zhu: Statistic Analysis; Jian Zou (Corresponding Author): Conceptualization, Funding Acquisition, Resources, Supervision, Writing-Review & Editing.
Corresponding author
Correspondence to Jian Zou .
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Ethics approval and consent to participate.
The study was approved by the Biomedical Research Ethics Committee of the West China Hospital of Sichuan University. Written informed consent was obtained from each guardian before they completed the questionnaire and PSG.The consent to participate was list in the appendix.
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The authors declare no competing interests.
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Lei, L., Zhang, X., Wang, B. et al. Effects of sleep-disordered breathing on serum lipid levels in children:a case control study. BMC Pediatr 24 , 220 (2024). https://doi.org/10.1186/s12887-024-04577-6
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DOI : https://doi.org/10.1186/s12887-024-04577-6
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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: Mixed methods case study. For a case study of a wind farm development in a ...
A case study is an in-depth analysis of specific, real-world situations or the scenarios inspired by them. Both teachers and professionals use them as training tools. They're used to present a problem, allowing individuals to interpret it and provide a solution. In the business world, organizations of many sizes use case studies to train ...
4 Benefits of a Case Study. A case study can allow you to: Collect wide-reaching data: Using a case study is an excellent way to gather large amounts of data on your subject, generally resulting in research that is more grounded in reality. For example, a case study approach focused on business research could have dozens of different data ...
A case study research paper examines a person, place, event, condition, phenomenon, or other type of subject of analysis in order to extrapolate key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity.
CASE STUDY definition: 1. a detailed account giving information about the development of a person, group, or thing…. Learn more.
case study: [noun] an intensive analysis of an individual unit (such as a person or community) stressing developmental factors in relation to environment.
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 ...
A business or marketing case study aims at showcasing a successful partnership. This can be between a brand and a client. Or the case study can examine a brand's project. There is a perception that case studies are used to advertise a brand. But effective reports, like the one below, can show clients how a brand can support them.
A case study is one of the most commonly used methodologies of social research. This article attempts to look into the various dimensions of a case study research strategy, the different epistemological strands which determine the particular case study type and approach adopted in the field, discusses the factors which can enhance the effectiveness of a case study research, and the debate ...
Résumé. Case study is a common methodology in the social sciences (management, psychology, science of education, political science, sociology). A lot of methodological papers have been dedicated to case study but, paradoxically, the question "what is a case?" has been less studied.
A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation. It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied.
Case studies are in-depth investigations of a person, group, event, or community. Typically, data is gathered from various sources using several methods (e.g., observations & interviews). The case study research method originated in clinical medicine (the case history, i.e., the patient's personal history). In psychology, case studies are ...
Instrumental Case Studies: These are conducted to understand a broader issue and use the specific case as a means to gain insights into the larger context. Collective Case Studies: Involving the study of multiple cases, this type allows for comparisons and contrasts, offering a more comprehensive view of a phenomenon or problem.
A case study is an in-depth, detailed examination of a particular case (or cases) within a real-world context. For example, case studies in medicine may focus on an individual patient or ailment; case studies in business might cover a particular firm's strategy or a broader market; similarly, case studies in politics can range from a narrow happening over time like the operations of a specific ...
Although case studies have been discussed extensively in the literature, little has been written about the specific steps one may use to conduct case study research effectively (Gagnon, 2010; Hancock & Algozzine, 2016).Baskarada (2014) also emphasized the need to have a succinct guideline that can be practically followed as it is actually tough to execute a case study well in practice.
Abstract. This paper aims to clarify the meaning, and explain the utility, of the case study method, a method often practiced but little understood. A "case study," I argue, is best defined as an intensive study of a single unit with an aim to generalize across a larger set of units. Case studies rely on the same sort of covariational ...
We also propose a more precise and encompassing definition that reconciles various definitions of case study research: case study is a transparadigmatic and transdisciplinary heuristic that involves the careful delineation of the phenomena for which evidence is being collected (event, concept, program, process, etc.).
Merriam-Webster's Dictionary defines a case study straightforwardly as follows:*. "Case Study. An intensive analysis of an individual unit (as a person or community) stressing developmental ...
What is a case study? A case study in medicine is a detailed report of a patient's experience with a disease, treatment, or condition. It typically includes the patient's medical history, symptoms, diagnostic tests, treatment course, and outcome. Some key things to know about medical case studies template. First, they delve deep into the ...
Global climate change is not a future problem. Changes to Earth's climate driven by increased human emissions of heat-trapping greenhouse gases are already having widespread effects on the environment: glaciers and ice sheets are shrinking, river and lake ice is breaking up earlier, plant and animal geographic ranges are shifting, and plants and trees are blooming sooner.
Background: Intravenous immunoglobulin (IVIg) for Clostridioides difficile infection (CDI) no longer features in treatment guidelines. However, IVIg is still used by some clinicians for severe or recurrent CDI (rCDI) cases. The main objective of this study was to investigate the efficacy of IVIg and to identify possible predictors of disease resolution post IVIg administration for patients ...
Background The discrepancy between blood supply and demand requires accurate forecasts of the blood supply at any blood bank. Accurate blood donation forecasting gives blood managers empirical evidence in blood inventory management. The study aims to model and predict blood donations in Zimbabwe using hierarchical time series. The modelling technique allows one to identify, say, a declining ...
Background Sleep-disordered breathing (SDB) during childhood is common and includes a range of breathing abnormalities that range from primary snoring (PS) to obstructive sleep apnea syndrome (OSAS).Studies have shown that not only OSAS, but also PS, which is originally considered harmless, could cause cardiovascular, cognitive, behavioral, and psychosocial problems. Many researches are ...