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5 Benefits of Learning Through the Case Study Method

Harvard Business School MBA students learning through the case study method

  • 28 Nov 2023

While several factors make HBS Online unique —including a global Community and real-world outcomes —active learning through the case study method rises to the top.

In a 2023 City Square Associates survey, 74 percent of HBS Online learners who also took a course from another provider said HBS Online’s case method and real-world examples were better by comparison.

Here’s a primer on the case method, five benefits you could gain, and how to experience it for yourself.

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What Is the Harvard Business School Case Study Method?

The case study method , or case method , is a learning technique in which you’re presented with a real-world business challenge and asked how you’d solve it. After working through it yourself and with peers, you’re told how the scenario played out.

HBS pioneered the case method in 1922. Shortly before, in 1921, the first case was written.

“How do you go into an ambiguous situation and get to the bottom of it?” says HBS Professor Jan Rivkin, former senior associate dean and chair of HBS's master of business administration (MBA) program, in a video about the case method . “That skill—the skill of figuring out a course of inquiry to choose a course of action—that skill is as relevant today as it was in 1921.”

Originally developed for the in-person MBA classroom, HBS Online adapted the case method into an engaging, interactive online learning experience in 2014.

In HBS Online courses , you learn about each case from the business professional who experienced it. After reviewing their videos, you’re prompted to take their perspective and explain how you’d handle their situation.

You then get to read peers’ responses, “star” them, and comment to further the discussion. Afterward, you learn how the professional handled it and their key takeaways.

HBS Online’s adaptation of the case method incorporates the famed HBS “cold call,” in which you’re called on at random to make a decision without time to prepare.

“Learning came to life!” said Sheneka Balogun , chief administration officer and chief of staff at LeMoyne-Owen College, of her experience taking the Credential of Readiness (CORe) program . “The videos from the professors, the interactive cold calls where you were randomly selected to participate, and the case studies that enhanced and often captured the essence of objectives and learning goals were all embedded in each module. This made learning fun, engaging, and student-friendly.”

If you’re considering taking a course that leverages the case study method, here are five benefits you could experience.

5 Benefits of Learning Through Case Studies

1. take new perspectives.

The case method prompts you to consider a scenario from another person’s perspective. To work through the situation and come up with a solution, you must consider their circumstances, limitations, risk tolerance, stakeholders, resources, and potential consequences to assess how to respond.

Taking on new perspectives not only can help you navigate your own challenges but also others’. Putting yourself in someone else’s situation to understand their motivations and needs can go a long way when collaborating with stakeholders.

2. Hone Your Decision-Making Skills

Another skill you can build is the ability to make decisions effectively . The case study method forces you to use limited information to decide how to handle a problem—just like in the real world.

Throughout your career, you’ll need to make difficult decisions with incomplete or imperfect information—and sometimes, you won’t feel qualified to do so. Learning through the case method allows you to practice this skill in a low-stakes environment. When facing a real challenge, you’ll be better prepared to think quickly, collaborate with others, and present and defend your solution.

3. Become More Open-Minded

As you collaborate with peers on responses, it becomes clear that not everyone solves problems the same way. Exposing yourself to various approaches and perspectives can help you become a more open-minded professional.

When you’re part of a diverse group of learners from around the world, your experiences, cultures, and backgrounds contribute to a range of opinions on each case.

On the HBS Online course platform, you’re prompted to view and comment on others’ responses, and discussion is encouraged. This practice of considering others’ perspectives can make you more receptive in your career.

“You’d be surprised at how much you can learn from your peers,” said Ratnaditya Jonnalagadda , a software engineer who took CORe.

In addition to interacting with peers in the course platform, Jonnalagadda was part of the HBS Online Community , where he networked with other professionals and continued discussions sparked by course content.

“You get to understand your peers better, and students share examples of businesses implementing a concept from a module you just learned,” Jonnalagadda said. “It’s a very good way to cement the concepts in one's mind.”

4. Enhance Your Curiosity

One byproduct of taking on different perspectives is that it enables you to picture yourself in various roles, industries, and business functions.

“Each case offers an opportunity for students to see what resonates with them, what excites them, what bores them, which role they could imagine inhabiting in their careers,” says former HBS Dean Nitin Nohria in the Harvard Business Review . “Cases stimulate curiosity about the range of opportunities in the world and the many ways that students can make a difference as leaders.”

Through the case method, you can “try on” roles you may not have considered and feel more prepared to change or advance your career .

5. Build Your Self-Confidence

Finally, learning through the case study method can build your confidence. Each time you assume a business leader’s perspective, aim to solve a new challenge, and express and defend your opinions and decisions to peers, you prepare to do the same in your career.

According to a 2022 City Square Associates survey , 84 percent of HBS Online learners report feeling more confident making business decisions after taking a course.

“Self-confidence is difficult to teach or coach, but the case study method seems to instill it in people,” Nohria says in the Harvard Business Review . “There may well be other ways of learning these meta-skills, such as the repeated experience gained through practice or guidance from a gifted coach. However, under the direction of a masterful teacher, the case method can engage students and help them develop powerful meta-skills like no other form of teaching.”

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How to Experience the Case Study Method

If the case method seems like a good fit for your learning style, experience it for yourself by taking an HBS Online course. Offerings span seven subject areas, including:

  • Business essentials
  • Leadership and management
  • Entrepreneurship and innovation
  • Finance and accounting
  • Business in society

No matter which course or credential program you choose, you’ll examine case studies from real business professionals, work through their challenges alongside peers, and gain valuable insights to apply to your career.

Are you interested in discovering how HBS Online can help advance your career? Explore our course catalog and download our free guide —complete with interactive workbook sections—to determine if online learning is right for you and which course to take.

advantage of case study

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advantage of case study

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

advantage of case study

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

Research question

  • Conceptual framework
  • Conceptual vs. theoretical framework

Data collection

  • Qualitative research methods
  • Focus groups
  • Observational research

What is a case study?

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

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

Case studies

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

advantage of case study

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

Definition of a case study

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

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

Characteristics of case studies

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

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

The role of case studies in research

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

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

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

What is the purpose of a case study?

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

Why use case studies in qualitative research?

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

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

The explanatory, exploratory, and descriptive roles of case studies

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

The impact of case studies on knowledge development

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

advantage of case study

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

Types of case studies

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

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

Exploratory case studies

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

Descriptive case studies

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

Explanatory case studies

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

advantage of case study

Intrinsic, instrumental, and collective case studies

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

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

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

Critical information systems research

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

Health research

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

advantage of case study

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

Asthma research studies

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

Other fields

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

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

advantage of case study

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

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


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

Units of analysis

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


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

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

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

Defining the research question

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

Selecting and defining the case

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

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

Developing a detailed case study protocol

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

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

Collecting data

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

Analyzing and interpreting data

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

Writing the case study report

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

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

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

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


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

Documents and artifacts

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

advantage of case study

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

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

Ensuring the quality of data collection

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

Data analysis

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

Organizing the data

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

Categorizing and coding the data

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

Identifying patterns and themes

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

Interpreting the data

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

Verification of the data

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

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

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

Benefits include the following:

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

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

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

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

advantage of case study

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Case Study Method – 18 Advantages and Disadvantages

The case study method uses investigatory research as a way to collect data about specific demographics. This approach can apply to individuals, businesses, groups, or events. Each participant receives an equal amount of participation, offering information for collection that can then find new insights into specific trends, ideas, of hypotheses.

Interviews and research observation are the two standard methods of data collection used when following the case study method.

Researchers initially developed the case study method to develop and support hypotheses in clinical medicine. The benefits found in these efforts led the approach to transition to other industries, allowing for the examination of results through proposed decisions, processes, or outcomes. Its unique approach to information makes it possible for others to glean specific points of wisdom that encourage growth.

Several case study method advantages and disadvantages can appear when researchers take this approach.

List of the Advantages of the Case Study Method

1. It requires an intensive study of a specific unit. Researchers must document verifiable data from direct observations when using the case study method. This work offers information about the input processes that go into the hypothesis under consideration. A casual approach to data-gathering work is not effective if a definitive outcome is desired. Each behavior, choice, or comment is a critical component that can verify or dispute the ideas being considered.

Intensive programs can require a significant amount of work for researchers, but it can also promote an improvement in the data collected. That means a hypothesis can receive immediate verification in some situations.

2. No sampling is required when following the case study method. This research method studies social units in their entire perspective instead of pulling individual data points out to analyze them. That means there is no sampling work required when using the case study method. The hypothesis under consideration receives support because it works to turn opinions into facts, verifying or denying the proposals that outside observers can use in the future.

Although researchers might pay attention to specific incidents or outcomes based on generalized behaviors or ideas, the study itself won’t sample those situations. It takes a look at the “bigger vision” instead.

3. This method offers a continuous analysis of the facts. The case study method will look at the facts continuously for the social group being studied by researchers. That means there aren’t interruptions in the process that could limit the validity of the data being collected through this work. This advantage reduces the need to use assumptions when drawing conclusions from the information, adding validity to the outcome of the study over time. That means the outcome becomes relevant to both sides of the equation as it can prove specific suppositions or invalidate a hypothesis under consideration.

This advantage can lead to inefficiencies because of the amount of data being studied by researchers. It is up to the individuals involved in the process to sort out what is useful and meaningful and what is not.

4. It is a useful approach to take when formulating a hypothesis. Researchers will use the case study method advantages to verify a hypothesis under consideration. It is not unusual for the collected data to lead people toward the formulation of new ideas after completing this work. This process encourages further study because it allows concepts to evolve as people do in social or physical environments. That means a complete data set can be gathered based on the skills of the researcher and the honesty of the individuals involved in the study itself.

Although this approach won’t develop a societal-level evaluation of a hypothesis, it can look at how specific groups will react in various circumstances. That information can lead to a better decision-making process in the future for everyone involved.

5. It provides an increase in knowledge. The case study method provides everyone with analytical power to increase knowledge. This advantage is possible because it uses a variety of methodologies to collect information while evaluating a hypothesis. Researchers prefer to use direct observation and interviews to complete their work, but it can also advantage through the use of questionnaires. Participants might need to fill out a journal or diary about their experiences that can be used to study behaviors or choices.

Some researchers incorporate memory tests and experimental tasks to determine how social groups will interact or respond in specific situations. All of this data then works to verify the possibilities that a hypothesis proposes.

6. The case study method allows for comparisons. The human experience is one that is built on individual observations from group situations. Specific demographics might think, act, or respond in particular ways to stimuli, but each person in that group will also contribute a small part to the whole. You could say that people are sponges that collect data from one another every day to create individual outcomes.

The case study method allows researchers to take the information from each demographic for comparison purposes. This information can then lead to proposals that support a hypothesis or lead to its disruption.

7. Data generalization is possible using the case study method. The case study method provides a foundation for data generalization, allowing researches to illustrate their statistical findings in meaningful ways. It puts the information into a usable format that almost anyone can use if they have the need to evaluate the hypothesis under consideration. This process makes it easier to discover unusual features, unique outcomes, or find conclusions that wouldn’t be available without this method. It does an excellent job of identifying specific concepts that relate to the proposed ideas that researchers were verifying through their work.

Generalization does not apply to a larger population group with the case study method. What researchers can do with this information is to suggest a predictable outcome when similar groups are placed in an equal situation.

8. It offers a comprehensive approach to research. Nothing gets ignored when using the case study method to collect information. Every person, place, or thing involved in the research receives the complete attention of those seeking data. The interactions are equal, which means the data is comprehensive and directly reflective of the group being observed.

This advantage means that there are fewer outliers to worry about when researching an idea, leading to a higher level of accuracy in the conclusions drawn by the researchers.

9. The identification of deviant cases is possible with this method. The case study method of research makes it easier to identify deviant cases that occur in each social group. These incidents are units (people) that behave in ways that go against the hypothesis under consideration. Instead of ignoring them like other options do when collecting data, this approach incorporates the “rogue” behavior to understand why it exists in the first place.

This advantage makes the eventual data and conclusions gathered more reliable because it incorporates the “alternative opinion” that exists. One might say that the case study method places as much emphasis on the yin as it does the yang so that the whole picture becomes available to the outside observer.

10. Questionnaire development is possible with the case study method. Interviews and direct observation are the preferred methods of implementing the case study method because it is cheap and done remotely. The information gathered by researchers can also lead to farming questionnaires that can farm additional data from those being studied. When all of the data resources come together, it is easier to formulate a conclusion that accurately reflects the demographics.

Some people in the case study method may try to manipulate the results for personal reasons, but this advantage makes it possible to identify this information readily. Then researchers can look into the thinking that goes into the dishonest behaviors observed.

List of the Disadvantages of the Case Study Method

1. The case study method offers limited representation. The usefulness of the case study method is limited to a specific group of representatives. Researchers are looking at a specific demographic when using this option. That means it is impossible to create any generalization that applies to the rest of society, an organization, or a larger community with this work. The findings can only apply to other groups caught in similar circumstances with the same experiences.

It is useful to use the case study method when attempting to discover the specific reasons why some people behave in a specific way. If researchers need something more generalized, then a different method must be used.

2. No classification is possible with the case study method. This disadvantage is also due to the sample size in the case study method. No classification is possible because researchers are studying such a small unit, group, or demographic. It can be an inefficient process since the skills of the researcher help to determine the quality of the data being collected to verify the validity of a hypothesis. Some participants may be unwilling to answer or participate, while others might try to guess at the outcome to support it.

Researchers can get trapped in a place where they explore more tangents than the actual hypothesis with this option. Classification can occur within the units being studied, but this data cannot extrapolate to other demographics.

3. The case study method still offers the possibility of errors. Each person has an unconscious bias that influences their behaviors and choices. The case study method can find outliers that oppose a hypothesis fairly easily thanks to its emphasis on finding facts, but it is up to the researchers to determine what information qualifies for this designation. If the results from the case study method are surprising or go against the opinion of participating individuals, then there is still the possibility that the information will not be 100% accurate.

Researchers must have controls in place that dictate how data gathering work occurs. Without this limitation in place, the results of the study cannot be guaranteed because of the presence of bias.

4. It is a subjective method to use for research. Although the purpose of the case study method of research is to gather facts, the foundation of what gets gathered is still based on opinion. It uses the subjective method instead of the objective one when evaluating data, which means there can be another layer of errors in the information to consider.

Imagine that a researcher interprets someone’s response as “angry” when performing direct observation, but the individual was feeling “shame” because of a decision they made. The difference between those two emotions is profound, and it could lead to information disruptions that could be problematic to the eventual work of hypothesis verification.

5. The processes required by the case study method are not useful for everyone. The case study method uses a person’s memories, explanations, and records from photographs and diaries to identify interactions on influences on psychological processes. People are given the chance to describe what happens in the world around them as a way for researchers to gather data. This process can be an advantage in some industries, but it can also be a worthless approach to some groups.

If the social group under study doesn’t have the information, knowledge, or wisdom to provide meaningful data, then the processes are no longer useful. Researchers must weigh the advantages and disadvantages of the case study method before starting their work to determine if the possibility of value exists. If it does not, then a different method may be necessary.

6. It is possible for bias to form in the data. It’s not just an unconscious bias that can form in the data when using the case study method. The narrow study approach can lead to outright discrimination in the data. Researchers can decide to ignore outliers or any other information that doesn’t support their hypothesis when using this method. The subjective nature of this approach makes it difficult to challenge the conclusions that get drawn from this work, and the limited pool of units (people) means that duplication is almost impossible.

That means unethical people can manipulate the results gathered by the case study method to their own advantage without much accountability in the process.

7. This method has no fixed limits to it. This method of research is highly dependent on situational circumstances rather than overarching societal or corporate truths. That means the researcher has no fixed limits of investigation. Even when controls are in place to limit bias or recommend specific activities, the case study method has enough flexibility built into its structures to allow for additional exploration. That means it is possible for this work to continue indefinitely, gathering data that never becomes useful.

Scientists began to track the health of 268 sophomores at Harvard in 1938. The Great Depression was in its final years at that point, so the study hoped to reveal clues that lead to happy and healthy lives. It continues still today, now incorporating the children of the original participants, providing over 80 years of information to sort through for conclusions.

8. The case study method is time-consuming and expensive. The case study method can be affordable in some situations, but the lack of fixed limits and the ability to pursue tangents can make it a costly process in most situations. It takes time to gather the data in the first place, and then researchers must interpret the information received so that they can use it for hypothesis evaluation. There are other methods of data collection that can be less expensive and provide results faster.

That doesn’t mean the case study method is useless. The individualization of results can help the decision-making process advance in a variety of industries successfully. It just takes more time to reach the appropriate conclusion, and that might be a resource that isn’t available.

The advantages and disadvantages of the case study method suggest that the helpfulness of this research option depends on the specific hypothesis under consideration. When researchers have the correct skills and mindset to gather data accurately, then it can lead to supportive data that can verify ideas with tremendous accuracy.

This research method can also be used unethically to produce specific results that can be difficult to challenge.

When bias enters into the structure of the case study method, the processes become inefficient, inaccurate, and harmful to the hypothesis. That’s why great care must be taken when designing a study with this approach. It might be a labor-intensive way to develop conclusions, but the outcomes are often worth the investments needed.

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

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

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

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

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

Table of contents

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

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

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

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

Case study examples
Research question Case study
What are the ecological effects of wolf reintroduction? Case study of wolf reintroduction in Yellowstone National Park
How do populist politicians use narratives about history to gain support? Case studies of Hungarian prime minister Viktor Orbán and US president Donald Trump
How can teachers implement active learning strategies in mixed-level classrooms? Case study of a local school that promotes active learning
What are the main advantages and disadvantages of wind farms for rural communities? Case studies of three rural wind farm development projects in different parts of the country
How are viral marketing strategies changing the relationship between companies and consumers? Case study of the iPhone X marketing campaign
How do experiences of work in the gig economy differ by gender, race and age? Case studies of Deliveroo and Uber drivers in London

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Research bias

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

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Research Method

Home » Case Study – Methods, Examples and Guide

Case Study – Methods, Examples and Guide

Table of Contents

Case Study Research

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 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.

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Case Study Research Method in Psychology

Saul Mcleod, PhD

Editor-in-Chief for Simply Psychology

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

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

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Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

On This Page:

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

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

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

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

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

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

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

case study

 Famous Case Studies

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

Clinical Case Studies

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

Child Psychology Case Studies

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

Types of Case Studies

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

Where Do You Find Data for a Case Study?

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

1. Primary sources

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

2. Secondary sources

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

3. Archival records

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

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

4. Organizational records

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

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

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

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

How do I Write a Case Study in Psychology?

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

1. Introduction

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

2. Case Presentation

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

3. Management and Outcome

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

4. Discussion

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

5. Additional Items

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Further Information

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

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What Is a Case Study?

Weighing the pros and cons of this method of research

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

advantage of case study

Cara Lustik is a fact-checker and copywriter.

advantage of case study

Verywell / Colleen Tighe

  • Pros and Cons

What Types of Case Studies Are Out There?

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

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

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

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

At a Glance

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

What Are the Benefits and Limitations of Case Studies?

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

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

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

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

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

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

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

Case Study Examples

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

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

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

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

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

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

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

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

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

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

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

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

Section 1: A Case History

This section will have the following structure and content:

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

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

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

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

Section 2: Treatment Plan

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

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

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

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

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

Need More Tips?

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

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

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

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

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

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

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


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Home » Pros and Cons » 12 Case Study Method Advantages and Disadvantages

12 Case Study Method Advantages and Disadvantages

A case study is an investigation into an individual circumstance. The investigation may be of a single person, business, event, or group. The investigation involves collecting in-depth data about the individual entity through the use of several collection methods. Interviews and observation are two of the most common forms of data collection used.

The case study method was originally developed in the field of clinical medicine. It has expanded since to other industries to examine key results, either positive or negative, that were received through a specific set of decisions. This allows for the topic to be researched with great detail, allowing others to glean knowledge from the information presented.

Here are the advantages and disadvantages of using the case study method.

List of the Advantages of the Case Study Method

1. it turns client observations into useable data..

Case studies offer verifiable data from direct observations of the individual entity involved. These observations provide information about input processes. It can show the path taken which led to specific results being generated. Those observations make it possible for others, in similar circumstances, to potentially replicate the results discovered by the case study method.

2. It turns opinion into fact.

Case studies provide facts to study because you’re looking at data which was generated in real-time. It is a way for researchers to turn their opinions into information that can be verified as fact because there is a proven path of positive or negative development. Singling out a specific incident also provides in-depth details about the path of development, which gives it extra credibility to the outside observer.

3. It is relevant to all parties involved.

Case studies that are chosen well will be relevant to everyone who is participating in the process. Because there is such a high level of relevance involved, researchers are able to stay actively engaged in the data collection process. Participants are able to further their knowledge growth because there is interest in the outcome of the case study. Most importantly, the case study method essentially forces people to make a decision about the question being studied, then defend their position through the use of facts.

4. It uses a number of different research methodologies.

The case study method involves more than just interviews and direct observation. Case histories from a records database can be used with this method. Questionnaires can be distributed to participants in the entity being studies. Individuals who have kept diaries and journals about the entity being studied can be included. Even certain experimental tasks, such as a memory test, can be part of this research process.

5. It can be done remotely.

Researchers do not need to be present at a specific location or facility to utilize the case study method. Research can be obtained over the phone, through email, and other forms of remote communication. Even interviews can be conducted over the phone. That means this method is good for formative research that is exploratory in nature, even if it must be completed from a remote location.

6. It is inexpensive.

Compared to other methods of research, the case study method is rather inexpensive. The costs associated with this method involve accessing data, which can often be done for free. Even when there are in-person interviews or other on-site duties involved, the costs of reviewing the data are minimal.

7. It is very accessible to readers.

The case study method puts data into a usable format for those who read the data and note its outcome. Although there may be perspectives of the researcher included in the outcome, the goal of this method is to help the reader be able to identify specific concepts to which they also relate. That allows them to discover unusual features within the data, examine outliers that may be present, or draw conclusions from their own experiences.

List of the Disadvantages of the Case Study Method

1. it can have influence factors within the data..

Every person has their own unconscious bias. Although the case study method is designed to limit the influence of this bias by collecting fact-based data, it is the collector of the data who gets to define what is a “fact” and what is not. That means the real-time data being collected may be based on the results the researcher wants to see from the entity instead. By controlling how facts are collected, a research can control the results this method generates.

2. It takes longer to analyze the data.

The information collection process through the case study method takes much longer to collect than other research options. That is because there is an enormous amount of data which must be sifted through. It’s not just the researchers who can influence the outcome in this type of research method. Participants can also influence outcomes by given inaccurate or incomplete answers to questions they are asked. Researchers must verify the information presented to ensure its accuracy, and that takes time to complete.

3. It can be an inefficient process.

Case study methods require the participation of the individuals or entities involved for it to be a successful process. That means the skills of the researcher will help to determine the quality of information that is being received. Some participants may be quiet, unwilling to answer even basic questions about what is being studied. Others may be overly talkative, exploring tangents which have nothing to do with the case study at all. If researchers are unsure of how to manage this process, then incomplete data is often collected.

4. It requires a small sample size to be effective.

The case study method requires a small sample size for it to yield an effective amount of data to be analyzed. If there are different demographics involved with the entity, or there are different needs which must be examined, then the case study method becomes very inefficient.

5. It is a labor-intensive method of data collection.

The case study method requires researchers to have a high level of language skills to be successful with data collection. Researchers must be personally involved in every aspect of collecting the data as well. From reviewing files or entries personally to conducting personal interviews, the concepts and themes of this process are heavily reliant on the amount of work each researcher is willing to put into things.

These case study method advantages and disadvantages offer a look at the effectiveness of this research option. With the right skill set, it can be used as an effective tool to gather rich, detailed information about specific entities. Without the right skill set, the case study method becomes inefficient and inaccurate.

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What are the benefits and drawbacks of case study research?

Posted by Mark Murphy | May 24, 2014 | Method , Research Students | 0

What are the benefits and drawbacks of case study research?

There should be no doubt that with case studies what you gain in depth you lose in breadth – this is the unavoidable compromise that needs to be understood from the beginning of the research process. So this is neither an advantage nor a disadvantage as one aspect cancels out the benefits/drawbacks of the other – there are other benefits and drawbacks that need attention however …

  • Their flexibility: case studies are popular for a number of reasons, one being that they can be conducted at various points in the research process. Researchers are known to favour them as a way to develop ideas for more extensive research in the future – pilot studies often take the form of case studies. They are also effective conduits for a broad range of research methods; in that sense they are non-prejudicial against any particular type of research – focus groups are just as welcome in case study research as are questionnaires or participant observation.
  • Capturing reality: One of their key benefits is their ability to capture what Hodkinson and Hodkinson call ‘lived reality’ (2001: 3). As they put it, case studies have the potential, when applied successfully, to ‘retain more of the “noise” of real life than many other types of research’ (Hodkinson and Hodkinson, 2001: 3). The importance of ‘noise’ and its place in research is especially important in contexts such as education, for example in schools where background noise is unavoidable. Educational contexts are always complex, and as a result it is difficult to exclude other unwanted variables, ‘some of which may only have real significance for one of their students’ (Hodkinson and Hodkinson, 2001, 4).
  • The challenge of generality: At the same time, given their specificity, care needs to be taken when attempting to generalise from the findings. While there’s no inherent flaw in case study design that precludes its broader application, it is preferable that researchers choose their case study sites carefully, while also basing their analysis within existing research findings that have been generated via other research designs. No design is infallible but so often has the claim against case studies been made, that some of the criticism (unwarranted and unfair in many cases) has stuck.
  • Suspicion of amateurism: Less partisan researchers might wonder whether the case study offers the time and finance-strapped researcher a convenient and pragmatic source of data, providing findings and recommendations that, given the nature of case studies, can neither be confirmed nor denied, in terms of utility or veracity. Who is to say that case studies offer anything more than a story to tell, and nothing more than that?
  • But alongside this suspicion is another more insiduous one – a notion that ‘stories’ are not what social science research is about. This can be a concern for those who favour  case study research, as the political consequences can be hard to ignore. That said, so much research is based either on peoples’ lives or the impact of other issues (poverty, institutional policy) on their lives, so the stories of what actually occurs in their lives or in professional environments tend to be an invaluable source of evidence. The fact is that stories (individual, collective, institutional) have a vital role to play in the world of research. And to play the specific v. general card against case study design suggests a tendency towards forms of research fundamentalism as opposed to any kind of rational and objective take on case study’s strengths and limitations.
  • Preciousness: Having said that, researchers should not fall into the trap (surprising how often this happens) of assuming that case study data speaks for itself – rarely is this ever the case, an assumption that is as patronising to research subjects as it is false. The role of the researcher is both to describe social phenomena and also to explain – i.e., interpret. Without interpretation the research findings lack meaningful presentation – they present themselves as fact when of course the reality of ‘facts’ is one of the reasons why such research is carried out.
  • Conflation of political/research objectives: Another trap that case study researchers sometimes fall into is presenting research findings as if they were self-evidently true, as if the stories were beyond criticism. This is often accompanied by a vague attachment to the notion that research is a political process – one that is performed as a form of liberation against for example policies that seek to ignore the stories of those who ‘suffer’ at the hands of overbearing political or economic imperatives. Case study design should not be viewed as a mechanism for providing a ‘local’ bulwark against the ‘global’ – bur rather as a mechanism for checking the veracity of universalist claims (at least one of its objectives). The valorisation of particularism can only get you so far in social research.

[This post is adapted from material in ‘Research and Education’ (Curtis, Murphy and Shields , Routledge 2014), pp. 80-82].

Reference: Hodkinson, P. and H. Hodkinson (2001). The strengths and limitations of case study research. Paper presented to the Learning and Skills Development Agency conference, Making an impact on policy and practice , Cambridge, 5-7 December 2001, downloaded from h ttp://education.exeter.ac.uk/tlc/docs/publications/LE_PH_PUB_05.12.01.rtf.26.01.2013

About The Author

Mark Murphy

Mark Murphy

Mark Murphy is a Reader in Education and Public Policy at the University of Glasgow. He previously worked as an academic at King’s College, London, University of Chester, University of Stirling, National University of Ireland, Maynooth, University College Dublin and Northern Illinois University. Mark is an active researcher in the fields of education and public policy. His research interests include educational sociology, critical theory, accountability in higher education, and public sector reform.

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Case Study Method: Definition, Research Types, Advantages

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by  Antony W

May 29, 2024

case study method

Case study method, or simply case study research methodology, is a technique that employs investigative inquiry to get data from specific individuals, organizations, groups, events, or demography.

Every participant in a case study method gets a similar engagement with hopes that he or she will provide information that helps with the discovery of novel insights on patterns, ideas, or hypothesis.

What’s The Origin of Case Study Method?

Frederic Le Play in France developed the case study method in sociology in 1829. Field workers would stay with families for a specific time and gather significant data such as income, expenditure, and interaction to understand the family in question.

The case study method was equally popular in clinical medicine, as it helped to generate, analyze, and support hypotheses .

Researchers adapted and integrated the technique to other sectors because of the benefits it uncovered in sociology, anthropology, and clinical medicine. The technique allows for the analysis of outcome through suggested decisions, procedures, and outcomes. 

What Research Types are Used in Case Study Method?

Your case study can be collective, descriptive, exploratory, explanatory, instrumental, or intrinsic.

These case study types require a comprehensive research methodology, which refers to procedures and techniques used to process and evaluate data to solve a problem and achieve a specific goal.

There are 2 types of research approaches for case studies: qualitative and quantitative research . These methods focus on different goals, data, and study.

Qualitative Research for Case Study

Qualitative research focuses on the collection and analysis of non-numerical data and it mostly applies to health sciences, anthropology, history, sociology, and education.

Examples of non-numerical data include audio, text, and video. You can collect qualitative data from focus groups, interviews, surveys, and observations.

Qualitative research for case studies enables you to generate new ideas and helpful insights with relevance and meaning.

Quantitative Research for Case Study

Quantitative research focuses on the collection and analysis of numbers, and it’s common in marketing, psychology, political science, economics, and sociology. Researchers use qualitative research to measure relationships and to test and track averages and patterns.

To do a comprehensive quantitative research:

  • Come up with a theory.
  • Develop a hypothesis.
  • Create a research pattern.
  • Operationalize a concept.
  • Find a research environment (site).
  • Choose your responders.
  • Gather, process, and analyze data.
  • Record your key findings and publish the results.

What are the Advantages of Case Study Methodology?

The following are the six advantages of the case study methodology:

1. Detailed Examination of a Specific Unit

The case study method enables researchers to document independently verifiable data from firsthand observations. The results provide information on the input mechanism that contributes to a proposed explanation under consideration.

2. Formation of Hypothesis

Researchers use the case study method to test a proposed hypothesis . More often than not, the information acquired from the study may inspire the formation of new concepts and allow further research because it supports change in social and physical settings.

You may collect a comprehensive data set depending on your ability and the openness of the study participants.

3. Constant Examination of Facts

You can use the case study methodology to examine facts about a social group continuously. The constant examination of facts ensures no disruption compromises the authenticity of the data obtained for the project.

Here, researchers don’t need to make assumptions when making conclusions from the collected data, thus ensuring the long-term validity of the findings. The conclusion made becomes significant to both sides of the equation, as it may confirm or reject the theory under investigation.

The constant examination of facts in case study methodology is subject to inefficiency because of the sheer volume of data under examination. Therefore, researchers have the responsibility to determine what information is helpful and what is insignificant.

4. Case Study Method Supports Comparison

Every demographic thinks, behaves, and responds to stimuli in unique ways, but each member of the group will contribute a little portion to a whole. Ideally, individual insights from different settings are a culmination of unique human experiences.

In this case, the case study method allows researchers to compare information from each demographic group, leading to ideas that either support or disapprove a theory.

5. Support for Knowledge Expansion

Researchers can use the case study methodology to expand their knowledge through analysis thanks to the range of methods used to collect data and evaluate hypothesis.

Many researchers collect data from interviews and observations, but even surveys can be just as useful. They may record participants’ experiences and use the information to analyze behavior and decisions. In some instances, a researcher may use memory test and experimental activities to predict how social groups would interact with or respond to given situations.

The information collected then serves to confirm the hypothesized possibilities.

6. Data Sampling Isn’t a Requirement

The case study method looks at social units holistically rather than isolating and analyzing individual data pieces. Therefore, the technique doesn’t require any sampling. The case study method supports the proposition under examination, as it transforms views into facts by validating or rejecting ideas that outside observers may use.

You may heed to specific incidences or results based on broader behavior or concepts. However, the study itself will not sample such instance. The methodology looks at the larger picture instead.

Where Can I Get Help With Case Study Writing?

You can get help with case study writing from Help for Assessment. We have the best case study writers who are only a click away to get you the writing you need to complete your paper on time.

It doesn’t matter if your deadline is closing in or you haven’t started working on the project yet. We can take you from a completely blank page to a well-written document before your due date. 

Help for Assessment charges $12.99 to $40 per page depending on the urgency. You get up to 10% discount if you’re new to this platform. So you can save money and still benefit from the convenience of our custom writing.

About the author 

Antony W is a professional writer and coach at Help for Assessment. He spends countless hours every day researching and writing great content filled with expert advice on how to write engaging essays, research papers, and assignments.

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Blog Beginner Guides 6 Types of Case Studies to Inspire Your Research and Analysis

6 Types of Case Studies to Inspire Your Research and Analysis

Written by: Ronita Mohan Sep 20, 2021

What is a Case Study Blog Header

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 case study templates .

Click to jump ahead:

What is a case study?

6 types of case studies, what is a business case study, what is a case study in research, what is a case study in psychology, what is the case study method, benefits of case studies, limitations of case studies, faqs about case studies.

A case study is a research process aimed at learning about a subject, an event or an organization. Case studies are use in business, the social sciences and healthcare.

A case study may focus on one observation or many. It can also examine a series of events or a single case. An effective case study tells a story and provides a conclusion.

Case Study Definition LinkedIn Post

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

Bold Social Media Business Case Study Template

Now that you know what a case study is, let’s look at the six different types of case studies next.

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.

6 Types Of Case Studies List

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.

Lead generation business case study template

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.

Bold Content Marketing Case Study Template

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.

Teal Social Media Business Case Study Template

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.

Vibrant Content Marketing Case Study Template

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.

Take the example of the fictional brand below.

Purple SAAS Business Case Study Template

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.

Social Media Business Case Study template

Related: 10+ Case Study Infographic Templates That Convert

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.

Light Simple Business Case Study Template

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 case study

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.

Modern lead Generation Business Case Study Template

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]

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.

What is a case study in research? UX Design case study example

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.

What is a case study in research? Spectrum healthcare example

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.

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.

What is a case study in psychology? Behavior therapy example

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]

The case study method, or case method, is a learning technique where you’re presented with a real-world business challenge and asked how you’d solve it.

After working through it independently and with peers, you learn how the actual scenario unfolded. This approach helps develop problem-solving skills and practical knowledge.

This method often uses various data sources like interviews, observations, and documents to provide comprehensive insights. 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.

Blue Simple Business Case Study Template

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.

Blue Content Marketing Case Study Template

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.

Coral content marketing case study template

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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Five Benefits of the Case-Based Study Method

M.S. in Commerce Student Ryann Sheehy discusses the benefits of the case-based study method.

M.S. in Commerce student ambassador Ryann Sheehy

Ryann Sheehy

M.S. in Commerce 2022

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When I first began the process of applying to graduate school, one of my biggest questions was how the work I did during my undergraduate years would compare to what would be expected of me in a graduate program. Many of my fears surrounded how difficult the homework and projects would be or how much time I’d have to spend in the library. Instead, what I found was that it wasn’t the subjective difficulty of a course or the number of hours I put into an assignment that was so different, but the overall shift in thinking we were being asked to make.

In the first few weeks of the M.S. in Commerce Program , my classmates and I were tasked with learning the language and tools of business quickly. And, in no better way was this achieved than through the case-based approach taken by our professors.

What is the case-based study method?

The case-based study method is a learning tool that allows students to read about a company and discuss their approaches to solving a presented problem faced by the firm. While this method is widely used in MBA programs, McIntire employs it across all of its programs at both the undergraduate and graduate level to challenge its students to apply practical business skills and course concepts.

How is it utilized in the classroom?

During the fall semester in the M.S. in Commerce Program, every class you take in the core curriculum will involve discussions of cases. Although the Strategy course taught by Professor Ira Harris will tackle the largest number of cases, every class from Accounting to Marketing will ask you to think critically about a real-life case whether in your small groups or as part of a larger class discussion.

So, why is the case-based approach used at McIntire, and what can it do for you? Here are five tangible benefits I’ve seen from this method that I believe give M.S. in Commerce students an advantage in the marketplace.

1. Discuss real-world scenarios

One of the most important learning objectives of the case-based study method—and, perhaps, the most obvious—is the practice with real-world scenarios. Professor Andrea Roberts, who teaches Cost Accounting in the fall semester, equates studying cases as the next best thing to actually placing students inside a real company. Many of the cases we are assigned are based on companies you may have heard of or have a personal experience with such as Trader Joe’s, Delta Air Lines, Peloton, and Wawa.

The emphasis on the real is even more clear in our Accounting classes, as we’re tasked with sifting through and interpreting actual financial statements taken directly from company reports. Roberts says one of the main objectives of these cases is to allow students to practice gathering information and figuring out what is relevant or even correctly stated. During our Cost Accounting class this semester, the case project we completed on the Alltel Pavilion was based on a real outdoor arena and included checking the financial reports for errors before calculating the answers. Although we are assigned some textbook problems to nail down the basic concepts, Roberts says it’s important to have experience with problems as they appear in practice—not nicely formatted or easily interpreted.

2. Learn from your peers

The deep level of diversity present across the program provides many opportunities for students to learn as much from their peers as they do from the professors. Phil Choi, a Business Analytics concentrator, said, “I actually do think that the M.S. in Commerce is really diverse. It’s not just a marketing thing; it actually is. The case approach takes advantage of that because you get to hear other people—their diverse experiences, whether that’s internships, whether that’s undergrad majors, or cultural diversity.” During in-class case discussions, students are encouraged to speak about their unique perspectives, since there are often many ways to look at the problem at hand. Choi said the case approach helps students who may be more reserved become comfortable with speaking their mind, as well as helps outspoken classmates learn to value other points of view.

3. Become comfortable with ambiguity

While many students may be used to finding the one best answer to a problem, in many of the cases we discuss, there truly is no perfect or “right” solution. Roberts describes this process as becoming “comfortable with the uncomfortableness.” While this change may be shocking to some students, it’s one of the most helpful lessons to learn before entering the workforce because your employer will not have an answer key to evaluate you with, nor will you be given all the necessary information in a neatly organized problem. The uncertainty pushes you to become more creative and look at all the options before deciding. As Harris teaches in Strategy, you cannot always make the right choice, but you can make an informed one.

4. Practice applying course concepts

Besides giving students real-world practice, one of the main objectives of studying cases is to practice applying the analytical tools and course concepts from class. For example, the case Harris calls a kind of “mid-range capstone” was the Delta Air Lines case we discussed after learning about benchmarking. Not only did the case cause us to discuss what makes successful versus failed benchmarking strategies, it also pulled together many of the concepts we had learned earlier in the semester. The connection between each case and a specific concept is also made clear, because we often discuss a new concept for the first part of class and then apply it to the case in the second half. This study method ultimately serves as a great way for students to test their overall understanding and ability to use the concepts taught in class when faced with a real issue.

5. Improve critical thinking and decision making

Last, but not least, cases are one of the main ways the M.S. in Commerce Program improves your ability to think critically and make informed decisions. In Roberts’ opinion, “Everything that you learn in M.S. in Commerce is providing information and tools so that you can make a decision.” Harris echoed that sentiment when he said, “When we talk about analytical thinking, when we talk about problem solving, it almost always is the use of a few different tools in order to gain some sort of a better understanding and to solve something that a company is facing.” At the end of the program, these cases will have served to improve your gut instincts and your ability to think quickly in future decision-making situations—a skill that you will need in everything from job interviews to your future day-to-day work.

What can prospective students do to prepare for this method of learning?

Harris recommends that prospective students begin familiarizing themselves with real-world business cases as soon as possible in order to gain a surface-level understanding of some of the key concepts and vocabulary that will come up in your McIntire courses. This is as easy as subscribing to and reading some of the world’s most popular business press such as The Wall Street Journal or Financial Times. Some of your current institutions may even give you free access to these sources.

If you’re interested in learning more about the case-based study method feel free to reach out to any of the current student ambassadors .

Learn more about the M.S. in Commerce program

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Definition of case study along with its advantages and disadvantages

advantage of case study

Case study is defined as “An event, an entity, an individual or even a unit of analysis” (Yin, 1989). A case study is also defined as an “Empirical inquiry that investigates a contemporary phenomenon within its real-life context using multiple sources of evidence” (Anderson, 1993). The case is also concerned on the reasoning of why and how the events happen so that the contextual realities could be captured and the variations in what was initially planned and what actually occurred could be perceived.

The case study is qualitative type of method; therefore, it has the same advantages as that of qualitative method. Case study can be either single or multiple cases. Single case is the analysis of one single phenomenon. According to Yin, Single cases are the most appropriate to confirm or challenge a theory or to represent a unique or extreme case.

Advantages of the case study:

  • As we can observe the case directly and relate it to theoretical part, we can get the data directly from the case and analyse it.
  • Results obtained through case study are more practical than ideal. As a researcher we observe and read the case directly: it is direct and simple method.
  • It is a flexible method of doing research, because researcher is free to discover and address issues as they arrive in their experiments.

Limitations of case study:

It narrows down the area of research: the research is limited to an individual or group individuals the results inferred by research are not universal. So it is difficult to generalise the results.

Anderson, G.J. (1993). Fundamentals of Educational Research. Falmer Press teachers’ library series. [Online]. Taylor & Francis Group. Available from: https://books.google.co.in/books?id=B5CGPwAACAAJ. Yin, R.K. (1989). Case study research: Design and methods. Applied Social Research Series. [Online]. London: Sage. Available from: http://citeseerx.ist.psu.edu/viewdoc/download?doi=


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How AI Can Change the Way Your Company Gets Work Done

  • Marc Zao-Sanders

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Using AI to help you carry out tasks better and faster can fuel new growth in your organization.

AI offers many ways to enhance a company’s overall internal capabilities and skills. AI can be used to infer skills from employee profiles and their activity. AI can be used to classify learning content and make it more applicable and accessible for the whole workforce, as well as making learning more personalized to each individual. AI can be used to summarize, recommend, and augment learning content. GenAI, in particular, can be used by the world’s billion knowledge workers to boost performance, right in the flow of work. Research shows that GenAI can get knowledge work done 25% faster and 40% better. This article covers several ways that corporations, teams, and individuals can drive internal growth by enhancing organizational capabilities. Early signs are that double-digit growth via GenAI is eminently possible.

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  • Marc Zao-Sanders is CEO and co-founder of filtered.com , which develops algorithmic technology to make sense of corporate skills and learning content. He’s the author of Timeboxing – The Power of Doing One Thing at a Time . Find Marc on LinkedIn or at www.marczaosanders.com .

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A group of 4 successful surgeons negotiate better contracts: a case study

How can a group of dedicated general surgeons transform their compensation and work conditions in six months? Here’s their story.

The group’s story: facts and dynamics

Four general surgeons, one NP, and one PA for a specific physician have been practicing at a small community hospital with three ancillary facilities in the Northeast for many years. The group and staffing have been dependable, without turnover, for the past three years. Three physicians have many years before retirement and are dedicated to staying in the community. One is planning to retire in three years. They provide a full range of surgical services, including trauma calls and assisting gastroenterology on weekends. They are at maximum work capacity, highly productive, and successful (production = 5.22 90th-percentile physicians). They want to hire a third party to help the team negotiate a new contract versus going alone.

What the group wants

  • Increase in pay and benefits, of course.
  • Update the structure and contents of the physician agreements with renegotiation targets at 2-3 years instead of 5-6 years.
  • Hire a new physician to increase the group to five in anticipation of the upcoming retirement.
  • Possible new operating room equipment, including resource and technology updates.
  • Will the hospital be open to negotiations with a third party?
  • Can the group of surgeons be on the same page?

For any progress to be made, all physicians must agree on terms and what they want. This unity and collaboration benefit the group and the health care community as a whole, fostering a sense of teamwork and shared goals. Fragmentation, back deals, side offers, and similar issues are common in negotiations, posing a significant challenge and potentially breaking groups apart. This facility faces multiple local, regional, and national challenges. These complexities underline the necessity for specialized services for group contract negotiations.

Leveraging third-party expertise in compensation strategy

Thoroughly analyze both sides—what the physicians want and what the hospital can afford to do. Using various data sources, determine the “fair market value” for the group in the particular location. Mediate with the hospital: Most physicians are not prepared for this process, either from a time or knowledge standpoint. The administration viewed the negotiations as a win-win for the hospital, community, and physicians.

Results: What happened?

The conversion factor per wRVU increased by $8 in year one, $10 in year two, and $12 in year three from the baseline number. They added a $50,000 quality bonus per year for each physician (which we were able to guarantee in year one). The call pay didn’t change in favor of the higher CF per wRVU. By running calculations using the last 12 months, the overall benefit to the group in year one will be $594,334 with the same level of production. Accounting for four surgeons, the average of the group (production did vary) will be over $148,000 in year one alone.

What physicians considering a group negotiation need to know

  • The total process took about 5-6 months. It’s not uncommon for this process to take longer, with the hospital dragging out the process, resulting in inaction or poor results.
  • All the surgeons did was invest a few hours upfront in calls and emails, send documents, and approve the asks/proposals/offers.
  • Able to put a ‘renegotiation’ piece in the agreement in three years—so can repeat the process to re-up this in three years (it was 5+ last time before they got an update or appropriate pay and benefits increase).
  • The administration enjoyed working with an expert third party, and the best part was that the physicians benefited with minimal effort.

Key takeaways

  • Physician employers: partners, not adversaries. They want physicians to be satisfied with their compensation arrangements. There is already a shortage of surgeons, and the number is expected to worsen. Replacement of surgeons poses financial, health care, and community challenges. They find it difficult to get a physician’s time and attention.
  • Even within the same group, physicians cannot decide what they want and have no clue what is “fair” since they do not have access to industry knowledge like hospitals do. We solve these issues. Often frustrated and underappreciated, physicians can find solace when their compensation is fair, a sentiment that physician employers may not always be aware of. Maximizing physician compensation reduces burnout. Many physicians know medicine but little about the business of medicine. It is essential to have tools to even the playing field so the team has the power of knowledge in negotiations.
  • Physicians: they are busy, overwhelmed, and skeptical. Despite their dedication to medicine, many physicians are locked into long-term agreements without updates. This lack of clarity can lead to uncertainty and feeling in the dark about their contracts, which could be improved with precise and updated agreements. They have difficulty agreeing on patient care, let alone what they want in their careers, which would improve their lives.

This case illustrates the importance of preparation, unity, and strategic communication in contract negotiations. The surgeons’ proactive approach improved their contractual conditions and set a precedent for future negotiations within the hospital.

Jon Appino has been the driving force behind  Contract Diagnostics since 2011, where he leads a dedicated team on a mission to empower physicians with the knowledge, tools, and confidence to negotiate robust employment contracts and secure the best compensation packages. With over a century of collective experience, the CDx team is a paragon of field expertise. With over 25 years of diverse health care experience, Jon leads this seasoned team of professionals. From Pete’s 20+ years to Anu’s 25+ years, complemented by Jillian and Laura’s 10+ years each, our team boasts a wealth of knowledge. This remarkable tenure is further fortified by the skills and backgrounds of our other team members, including Kathryn Sarnoski, MD, and Jan Schmitz, director of operations. Their combined experience ensures that Contract Diagnostics offers the most seasoned and insightful guidance in physician compensation.

Discover more of Jon’s perspectives on physician compensation by exploring the Contract Diagnostics blog or connecting on social media platforms like LinkedIn ,  Facebook ,  YouTube , and  Instagram .

The  Contract Diagnostics  team offers comprehensive consulting services tailored to physicians and their families, addressing employment contracts and compensation structures. Our expertise spans contract physician compensation, schedules, benefits, and more.

Our mission is to establish a central resource where physicians can access information, consulting, and coaching to navigate the intricacies of employment contracts and compensation structures, ensuring equitable remuneration.

Questions? Feel free to reach out to us via our  website  or at 888-574-5526.

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Human Subjects Office

Medical terms in lay language.

Please use these descriptions in place of medical jargon in consent documents, recruitment materials and other study documents. Note: These terms are not the only acceptable plain language alternatives for these vocabulary words.

This glossary of terms is derived from a list copyrighted by the University of Kentucky, Office of Research Integrity (1990).

For clinical research-specific definitions, see also the Clinical Research Glossary developed by the Multi-Regional Clinical Trials (MRCT) Center of Brigham and Women’s Hospital and Harvard  and the Clinical Data Interchange Standards Consortium (CDISC) .

Alternative Lay Language for Medical Terms for use in Informed Consent Documents

A   B   C   D   E   F   G   H   I  J  K   L   M   N   O   P   Q   R   S   T   U   V   W  X  Y  Z

ABDOMEN/ABDOMINAL body cavity below diaphragm that contains stomach, intestines, liver and other organs ABSORB take up fluids, take in ACIDOSIS condition when blood contains more acid than normal ACUITY clearness, keenness, esp. of vision and airways ACUTE new, recent, sudden, urgent ADENOPATHY swollen lymph nodes (glands) ADJUVANT helpful, assisting, aiding, supportive ADJUVANT TREATMENT added treatment (usually to a standard treatment) ANTIBIOTIC drug that kills bacteria and other germs ANTIMICROBIAL drug that kills bacteria and other germs ANTIRETROVIRAL drug that works against the growth of certain viruses ADVERSE EFFECT side effect, bad reaction, unwanted response ALLERGIC REACTION rash, hives, swelling, trouble breathing AMBULATE/AMBULATION/AMBULATORY walk, able to walk ANAPHYLAXIS serious, potentially life-threatening allergic reaction ANEMIA decreased red blood cells; low red cell blood count ANESTHETIC a drug or agent used to decrease the feeling of pain, or eliminate the feeling of pain by putting you to sleep ANGINA pain resulting from not enough blood flowing to the heart ANGINA PECTORIS pain resulting from not enough blood flowing to the heart ANOREXIA disorder in which person will not eat; lack of appetite ANTECUBITAL related to the inner side of the forearm ANTIBODY protein made in the body in response to foreign substance ANTICONVULSANT drug used to prevent seizures ANTILIPEMIC a drug that lowers fat levels in the blood ANTITUSSIVE a drug used to relieve coughing ARRHYTHMIA abnormal heartbeat; any change from the normal heartbeat ASPIRATION fluid entering the lungs, such as after vomiting ASSAY lab test ASSESS to learn about, measure, evaluate, look at ASTHMA lung disease associated with tightening of air passages, making breathing difficult ASYMPTOMATIC without symptoms AXILLA armpit

BENIGN not malignant, without serious consequences BID twice a day BINDING/BOUND carried by, to make stick together, transported BIOAVAILABILITY the extent to which a drug or other substance becomes available to the body BLOOD PROFILE series of blood tests BOLUS a large amount given all at once BONE MASS the amount of calcium and other minerals in a given amount of bone BRADYARRHYTHMIAS slow, irregular heartbeats BRADYCARDIA slow heartbeat BRONCHOSPASM breathing distress caused by narrowing of the airways

CARCINOGENIC cancer-causing CARCINOMA type of cancer CARDIAC related to the heart CARDIOVERSION return to normal heartbeat by electric shock CATHETER a tube for withdrawing or giving fluids CATHETER a tube placed near the spinal cord and used for anesthesia (indwelling epidural) during surgery CENTRAL NERVOUS SYSTEM (CNS) brain and spinal cord CEREBRAL TRAUMA damage to the brain CESSATION stopping CHD coronary heart disease CHEMOTHERAPY treatment of disease, usually cancer, by chemical agents CHRONIC continuing for a long time, ongoing CLINICAL pertaining to medical care CLINICAL TRIAL an experiment involving human subjects COMA unconscious state COMPLETE RESPONSE total disappearance of disease CONGENITAL present before birth CONJUNCTIVITIS redness and irritation of the thin membrane that covers the eye CONSOLIDATION PHASE treatment phase intended to make a remission permanent (follows induction phase) CONTROLLED TRIAL research study in which the experimental treatment or procedure is compared to a standard (control) treatment or procedure COOPERATIVE GROUP association of multiple institutions to perform clinical trials CORONARY related to the blood vessels that supply the heart, or to the heart itself CT SCAN (CAT) computerized series of x-rays (computerized tomography) CULTURE test for infection, or for organisms that could cause infection CUMULATIVE added together from the beginning CUTANEOUS relating to the skin CVA stroke (cerebrovascular accident)

DERMATOLOGIC pertaining to the skin DIASTOLIC lower number in a blood pressure reading DISTAL toward the end, away from the center of the body DIURETIC "water pill" or drug that causes increase in urination DOPPLER device using sound waves to diagnose or test DOUBLE BLIND study in which neither investigators nor subjects know what drug or treatment the subject is receiving DYSFUNCTION state of improper function DYSPLASIA abnormal cells

ECHOCARDIOGRAM sound wave test of the heart EDEMA excess fluid collecting in tissue EEG electric brain wave tracing (electroencephalogram) EFFICACY effectiveness ELECTROCARDIOGRAM electrical tracing of the heartbeat (ECG or EKG) ELECTROLYTE IMBALANCE an imbalance of minerals in the blood EMESIS vomiting EMPIRIC based on experience ENDOSCOPIC EXAMINATION viewing an  internal part of the body with a lighted tube  ENTERAL by way of the intestines EPIDURAL outside the spinal cord ERADICATE get rid of (such as disease) Page 2 of 7 EVALUATED, ASSESSED examined for a medical condition EXPEDITED REVIEW rapid review of a protocol by the IRB Chair without full committee approval, permitted with certain low-risk research studies EXTERNAL outside the body EXTRAVASATE to leak outside of a planned area, such as out of a blood vessel

FDA U.S. Food and Drug Administration, the branch of federal government that approves new drugs FIBROUS having many fibers, such as scar tissue FIBRILLATION irregular beat of the heart or other muscle

GENERAL ANESTHESIA pain prevention by giving drugs to cause loss of consciousness, as during surgery GESTATIONAL pertaining to pregnancy

HEMATOCRIT amount of red blood cells in the blood HEMATOMA a bruise, a black and blue mark HEMODYNAMIC MEASURING blood flow HEMOLYSIS breakdown in red blood cells HEPARIN LOCK needle placed in the arm with blood thinner to keep the blood from clotting HEPATOMA cancer or tumor of the liver HERITABLE DISEASE can be transmitted to one’s offspring, resulting in damage to future children HISTOPATHOLOGIC pertaining to the disease status of body tissues or cells HOLTER MONITOR a portable machine for recording heart beats HYPERCALCEMIA high blood calcium level HYPERKALEMIA high blood potassium level HYPERNATREMIA high blood sodium level HYPERTENSION high blood pressure HYPOCALCEMIA low blood calcium level HYPOKALEMIA low blood potassium level HYPONATREMIA low blood sodium level HYPOTENSION low blood pressure HYPOXEMIA a decrease of oxygen in the blood HYPOXIA a decrease of oxygen reaching body tissues HYSTERECTOMY surgical removal of the uterus, ovaries (female sex glands), or both uterus and ovaries

IATROGENIC caused by a physician or by treatment IDE investigational device exemption, the license to test an unapproved new medical device IDIOPATHIC of unknown cause IMMUNITY defense against, protection from IMMUNOGLOBIN a protein that makes antibodies IMMUNOSUPPRESSIVE drug which works against the body's immune (protective) response, often used in transplantation and diseases caused by immune system malfunction IMMUNOTHERAPY giving of drugs to help the body's immune (protective) system; usually used to destroy cancer cells IMPAIRED FUNCTION abnormal function IMPLANTED placed in the body IND investigational new drug, the license to test an unapproved new drug INDUCTION PHASE beginning phase or stage of a treatment INDURATION hardening INDWELLING remaining in a given location, such as a catheter INFARCT death of tissue due to lack of blood supply INFECTIOUS DISEASE transmitted from one person to the next INFLAMMATION swelling that is generally painful, red, and warm INFUSION slow injection of a substance into the body, usually into the blood by means of a catheter INGESTION eating; taking by mouth INTERFERON drug which acts against viruses; antiviral agent INTERMITTENT occurring (regularly or irregularly) between two time points; repeatedly stopping, then starting again INTERNAL within the body INTERIOR inside of the body INTRAMUSCULAR into the muscle; within the muscle INTRAPERITONEAL into the abdominal cavity INTRATHECAL into the spinal fluid INTRAVENOUS (IV) through the vein INTRAVESICAL in the bladder INTUBATE the placement of a tube into the airway INVASIVE PROCEDURE puncturing, opening, or cutting the skin INVESTIGATIONAL NEW DRUG (IND) a new drug that has not been approved by the FDA INVESTIGATIONAL METHOD a treatment method which has not been proven to be beneficial or has not been accepted as standard care ISCHEMIA decreased oxygen in a tissue (usually because of decreased blood flow)

LAPAROTOMY surgical procedure in which an incision is made in the abdominal wall to enable a doctor to look at the organs inside LESION wound or injury; a diseased patch of skin LETHARGY sleepiness, tiredness LEUKOPENIA low white blood cell count LIPID fat LIPID CONTENT fat content in the blood LIPID PROFILE (PANEL) fat and cholesterol levels in the blood LOCAL ANESTHESIA creation of insensitivity to pain in a small, local area of the body, usually by injection of numbing drugs LOCALIZED restricted to one area, limited to one area LUMEN the cavity of an organ or tube (e.g., blood vessel) LYMPHANGIOGRAPHY an x-ray of the lymph nodes or tissues after injecting dye into lymph vessels (e.g., in feet) LYMPHOCYTE a type of white blood cell important in immunity (protection) against infection LYMPHOMA a cancer of the lymph nodes (or tissues)

MALAISE a vague feeling of bodily discomfort, feeling badly MALFUNCTION condition in which something is not functioning properly MALIGNANCY cancer or other progressively enlarging and spreading tumor, usually fatal if not successfully treated MEDULLABLASTOMA a type of brain tumor MEGALOBLASTOSIS change in red blood cells METABOLIZE process of breaking down substances in the cells to obtain energy METASTASIS spread of cancer cells from one part of the body to another METRONIDAZOLE drug used to treat infections caused by parasites (invading organisms that take up living in the body) or other causes of anaerobic infection (not requiring oxygen to survive) MI myocardial infarction, heart attack MINIMAL slight MINIMIZE reduce as much as possible Page 4 of 7 MONITOR check on; keep track of; watch carefully MOBILITY ease of movement MORBIDITY undesired result or complication MORTALITY death MOTILITY the ability to move MRI magnetic resonance imaging, diagnostic pictures of the inside of the body, created using magnetic rather than x-ray energy MUCOSA, MUCOUS MEMBRANE moist lining of digestive, respiratory, reproductive, and urinary tracts MYALGIA muscle aches MYOCARDIAL pertaining to the heart muscle MYOCARDIAL INFARCTION heart attack

NASOGASTRIC TUBE placed in the nose, reaching to the stomach NCI the National Cancer Institute NECROSIS death of tissue NEOPLASIA/NEOPLASM tumor, may be benign or malignant NEUROBLASTOMA a cancer of nerve tissue NEUROLOGICAL pertaining to the nervous system NEUTROPENIA decrease in the main part of the white blood cells NIH the National Institutes of Health NONINVASIVE not breaking, cutting, or entering the skin NOSOCOMIAL acquired in the hospital

OCCLUSION closing; blockage; obstruction ONCOLOGY the study of tumors or cancer OPHTHALMIC pertaining to the eye OPTIMAL best, most favorable or desirable ORAL ADMINISTRATION by mouth ORTHOPEDIC pertaining to the bones OSTEOPETROSIS rare bone disorder characterized by dense bone OSTEOPOROSIS softening of the bones OVARIES female sex glands

PARENTERAL given by injection PATENCY condition of being open PATHOGENESIS development of a disease or unhealthy condition PERCUTANEOUS through the skin PERIPHERAL not central PER OS (PO) by mouth PHARMACOKINETICS the study of the way the body absorbs, distributes, and gets rid of a drug PHASE I first phase of study of a new drug in humans to determine action, safety, and proper dosing PHASE II second phase of study of a new drug in humans, intended to gather information about safety and effectiveness of the drug for certain uses PHASE III large-scale studies to confirm and expand information on safety and effectiveness of new drug for certain uses, and to study common side effects PHASE IV studies done after the drug is approved by the FDA, especially to compare it to standard care or to try it for new uses PHLEBITIS irritation or inflammation of the vein PLACEBO an inactive substance; a pill/liquid that contains no medicine PLACEBO EFFECT improvement seen with giving subjects a placebo, though it contains no active drug/treatment PLATELETS small particles in the blood that help with clotting POTENTIAL possible POTENTIATE increase or multiply the effect of a drug or toxin (poison) by giving another drug or toxin at the same time (sometimes an unintentional result) POTENTIATOR an agent that helps another agent work better PRENATAL before birth PROPHYLAXIS a drug given to prevent disease or infection PER OS (PO) by mouth PRN as needed PROGNOSIS outlook, probable outcomes PRONE lying on the stomach PROSPECTIVE STUDY following patients forward in time PROSTHESIS artificial part, most often limbs, such as arms or legs PROTOCOL plan of study PROXIMAL closer to the center of the body, away from the end PULMONARY pertaining to the lungs

QD every day; daily QID four times a day

RADIATION THERAPY x-ray or cobalt treatment RANDOM by chance (like the flip of a coin) RANDOMIZATION chance selection RBC red blood cell RECOMBINANT formation of new combinations of genes RECONSTITUTION putting back together the original parts or elements RECUR happen again REFRACTORY not responding to treatment REGENERATION re-growth of a structure or of lost tissue REGIMEN pattern of giving treatment RELAPSE the return of a disease REMISSION disappearance of evidence of cancer or other disease RENAL pertaining to the kidneys REPLICABLE possible to duplicate RESECT remove or cut out surgically RETROSPECTIVE STUDY looking back over past experience

SARCOMA a type of cancer SEDATIVE a drug to calm or make less anxious SEMINOMA a type of testicular cancer (found in the male sex glands) SEQUENTIALLY in a row, in order SOMNOLENCE sleepiness SPIROMETER an instrument to measure the amount of air taken into and exhaled from the lungs STAGING an evaluation of the extent of the disease STANDARD OF CARE a treatment plan that the majority of the medical community would accept as appropriate STENOSIS narrowing of a duct, tube, or one of the blood vessels in the heart STOMATITIS mouth sores, inflammation of the mouth STRATIFY arrange in groups for analysis of results (e.g., stratify by age, sex, etc.) STUPOR stunned state in which it is difficult to get a response or the attention of the subject SUBCLAVIAN under the collarbone SUBCUTANEOUS under the skin SUPINE lying on the back SUPPORTIVE CARE general medical care aimed at symptoms, not intended to improve or cure underlying disease SYMPTOMATIC having symptoms SYNDROME a condition characterized by a set of symptoms SYSTOLIC top number in blood pressure; pressure during active contraction of the heart

TERATOGENIC capable of causing malformations in a fetus (developing baby still inside the mother’s body) TESTES/TESTICLES male sex glands THROMBOSIS clotting THROMBUS blood clot TID three times a day TITRATION a method for deciding on the strength of a drug or solution; gradually increasing the dose T-LYMPHOCYTES type of white blood cells TOPICAL on the surface TOPICAL ANESTHETIC applied to a certain area of the skin and reducing pain only in the area to which applied TOXICITY side effects or undesirable effects of a drug or treatment TRANSDERMAL through the skin TRANSIENTLY temporarily TRAUMA injury; wound TREADMILL walking machine used to test heart function

UPTAKE absorbing and taking in of a substance by living tissue

VALVULOPLASTY plastic repair of a valve, especially a heart valve VARICES enlarged veins VASOSPASM narrowing of the blood vessels VECTOR a carrier that can transmit disease-causing microorganisms (germs and viruses) VENIPUNCTURE needle stick, blood draw, entering the skin with a needle VERTICAL TRANSMISSION spread of disease

WBC white blood cell

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For more than a decade, Britain has been governed by the Conservative Party, which pushed its politics to the right, embracing smaller government and Brexit. Last week, that era officially came to an end.

Mark Landler, the London bureau chief for The Times, explains why British voters rejected the Conservatives and what their defeat means in a world where populism is on the rise.

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  • Published: 05 July 2024

Comparison of robot-assisted versus fluoroscopy-guided transforaminal lumbar interbody fusion (TLIF) for lumbar degenerative diseases: a systematic review and meta-analysis of randomized controlled trails and cohort studies

  • Jianbin Guan 1 , 2 ,
  • Ningning Feng 3 ,
  • Xing Yu 3 &
  • Kaitan Yang 1 , 4  

Systematic Reviews volume  13 , Article number:  170 ( 2024 ) Cite this article

69 Accesses

Metrics details

As an emerging technology in robot-assisted (RA) surgery, the potential benefits of its application in transforaminal lumbar interbody fusion (TLIF) lack substantial support from current evidence.

We aimed to investigate whether the RA TLIF is superior to FG TLIF in the treatment of lumbar degenerative disease.

We systematically reviewed studies comparing RA versus FG TLIF for lumbar degenerative diseases through July 2022 by searching PubMed, Embase, Web of Science, CINAHL (EBSCO), Chinese National Knowledge Infrastructure (CNKI), WanFang, VIP, and the Cochrane Library, as well as the references of published review articles. Both cohort studies (CSs) and randomized controlled trials (RCTs) were included. Evaluation criteria included the accuracy of percutaneous pedicle screw placement, proximal facet joint violation (FJV), radiation exposure, duration of surgery, estimated blood loss (EBL), and surgical revision. Methodological quality was assessed using the Cochrane risk of bias and ROBINS-I Tool. Random-effects models were used, and the standardized mean difference (SMD) was employed as the effect measure. We conducted subgroup analyses based on surgical type, the specific robot system used, and the study design. Two investigators independently screened abstracts and full-text articles, and the certainty of evidence was graded using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

Our search identified 539 articles, of which 21 met the inclusion criteria for quantitative analysis. Meta-analysis revealed that RA had 1.03-folds higher “clinically acceptable” accuracy than FG (RR: 1.0382, 95% CI: 1.0273–1.0493). And RA had 1.12-folds higher “perfect” accuracy than FG group (RR: 1.1167, 95% CI: 1.0726–1.1626). In the case of proximal FJV, our results indicate a 74% reduction in occurrences for patients undergoing RA pedicle screw placement compared to those in the FG group (RR: 0.2606, 95%CI: 0.2063- 0.3293). Seventeen CSs and two RCTs reported the duration of time. The results of CSs suggest that there is no significant difference between RA and FG group (SMD: 0.1111, 95%CI: -0.391–0.6131), but the results of RCTs suggest that the patients who underwent RA-TLIF need more surgery time than FG (SMD: 3.7213, 95%CI: 3.0756–4.3669). Sixteen CSs and two RCTs reported the EBL. The results suggest that the patients who underwent RA pedicle screw placement had fewer EBL than FG group (CSs: SMD: -1.9151, 95%CI: -3.1265–0.7036, RCTs: SMD: -5.9010, 95%CI: -8.7238–3.0782). For radiation exposure, the results of CSs suggest that there is no significant difference in radiation time between RA and FG group (SMD: -0.5256, 95%CI: -1.4357–0.3845), but the patients who underwent RA pedicle screw placement had fewer radiation dose than FG group (SMD: -2.2682, 95%CI: -3.1953–1.3411). And four CSs and one RCT reported the number of revision case. The results of CSs suggest that there is no significant difference in the number of revision case between RA and FG group (RR: 0.4087,95% CI 0.1592–1.0495). Our findings are limited by the residual heterogeneity of the included studies, which may limit the interpretation of the results.

In TLIF, RA technology exhibits enhanced precision in pedicle screw placement when compared to FG methods. This accuracy contributes to advantages such as the protection of adjacent facet joints and reductions in intraoperative radiation dosage and blood loss. However, the longer preoperative preparation time associated with RA procedures results in comparable surgical duration and radiation time to FG techniques. Presently, FG screw placement remains the predominant approach, with clinical surgeons possessing greater proficiency in its application. Consequently, the integration of RA into TLIF surgery may not be considered the optimal choice.

Systematic review registration

PROSPERO CRD42023441600.

Peer Review reports


Since the first report of transforaminal lumbar interbody fusion (TLIF) for the treatment of lumbar spondylolisthesis by Harms and Rolinger et al. [ 1 ] in 1982, TLIF has progressively evolved into a standard surgical procedure for addressing lumbar degenerative diseases [ 2 ]. Subsequently, Foley et al. [ 3 ] further advanced TLIF by introducing the minimally invasive technique (Wiltse technique). This breakthrough facilitated the initial adoption of minimally invasive surgery (MIS) in TLIF, leading to decreased surgical trauma, accelerated recovery, and an overall alleviation of the patient's daily life burden. Nevertheless, TLIF is not without its drawbacks, including prolonged surgical time and a steep learning curve. The duration of the surgery frequently hinges on the surgeon's proficiency in mastering technical skills [ 4 , 5 ]. The restricted operating field frequently results in imprecise screw placement, often requiring additional corrective surgeries. To guarantee optimal accuracy in screw placement, real-time fluoroscopic examination is typically considered essential throughout the procedure. Consequently, the potential for excessive radiation exposure during MIS-TLIF remains a significant concern [ 6 , 7 ]. Undoubtedly, whether it is fluoroscopy-guided (FG) TLIF or MIS-TLIF, the most critical aspect of the surgical procedure is the swift and accurate placement of pedicle screws. This objective is paramount in reducing surgical time, minimizing intraoperative bleeding, enhancing surgical outcomes, lowering the rate of revision surgeries, and mitigating radiation exposure. Therefore, achieving expedient and precise placement of pedicle screws remains an urgent concern in TLIF.

The integration of robotic technology into spine surgery has offered a solution for achieving accurate and efficient pedicle screw placement. Robotics can assist surgeons in precise navigation and access to critical anatomical structures during spinal surgery, leveraging 3D imaging. Furthermore, the employment of surgical robots for pedicle screw placement ensures both safety and accuracy, while also minimizing the surgeon's exposure to intraoperative radiation. However, at present, FG techniques persist as the predominant method for screw insertion in TLIF, with surgeons exhibiting greater proficiency in its application. As a nascent robot-assisted (RA) technology, the potential superiority of its application in TLIF surgery has not yet been substantiated by relevant evidence. Furthermore, opting for RA procedures in TLIF imposes a heightened financial burden on patients compared to traditional FG-TLIF. Consequently, the suitability of integrating RA technology into TLIF surgery remains uncertain [ 8 , 9 ]. In order to examine the potential advantages of RA in terms of screw placement accuracy and its ability to address the limitations of FG in TLIF, we conducted a systematic review and meta-analysis.

This systematic review and meta-analysis are performed based on the guidance of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA, Text 1) and Cochrane Handbook for Systematic Reviews of Interventions [ 10 , 11 ]. No ethical approval and patient consent are required because all analyses are based on previous published studies. The full protocol for this study is available in the supplementary material (Text 2). Literature search, data extraction, data synthesis, and quality assessment were conducted by at least two professional reviewers. The review protocols were retrospective registered on PROSPERO (International Prospective Register of Systematic Reviews, No. CRD42023441600). Our study was conducted retrospectively on July 12, 2022. The retrospective registration in no way compromises the quality, validity, or integrity of the research findings presented in this manuscript. All research procedures, data collection, and data analysis were carried out systematically and well-documented, ensuring the reliability and reproducibility of our results.

Search strategy and selection criteria

We systematically searched several databases, including PubMed, Excerpta Medical database (Embase), Web of Science, CINAHL (EBSCO), China National Knowledge Infrastructure (CNKI), WanFang Database (WanFang), China Science and Technology Journal Database (VIP), and the Cochrane Library, from inception to July 2022 using the following keywords combined with MeSH terms: 'robot-assisted,' 'fluoroscopy-assisted,' 'lumbar surgery,' 'spinal surgery,' 'transforaminal lumbar interbody fusion,' and 'minimally invasive surgery,' 'TLIF,' 'MIS-TLIF,' 'RA,' 'FG,' and 'lumbar degenerative diseases.' Search terms were combined using the Boolean operators 'AND' or 'OR.' Furthermore, the reference lists of manuscripts were also hand-searched to ensure that some studies, which were not identified by our original search, were also included in the present study. The complete search strategies were shown in Supplementary material 1.

We incorporated all types of relevant studies, encompassing randomized controlled trials (RCTs) as well as prospective and retrospective cohort studies (CSs). The study population comprised patients diagnosed with degenerative lumbar spinal diseases, such as spondylolisthesis and lumbar spinal stenosis, who underwent treatment via TLIF. In the included studies, the intervention group must be RA TLIF, and the control group is FG TLIF (Table  1 ). The following exclusion criteria were used: (1) studies with insufficient data; (2) cadaveric and animal studies; (3) sample size per arm < 10 participants; and (4) patients with other treatment. Moreover, there were no language restrictions.

Data extraction and synthesis

The two reviewers (JB.G and NN.F) extracted data independently using a standardized form. The following factors were recorded when the information in the reviewed articles was available: first author, year, participants and surgery, type of surgery, type of robot system, sample size, age, sex, study design, intra-pedicular accuracy, proximal facet joint violation (FJV), duration of surgery, estimated blood loss (EBL), radiation time and dose, and revision case. Any disagreements between the reviewers (JB.G and NN.F) were resolved through discussion. In case of insolvable discrepancies, a third reviewer (KT.Y) acted as an arbitrator.

The primary outcomes include the accuracy of percutaneous pedicle screw placement and the occurrence of proximal facet joint violation (FJV). For intra-pedicular accuracy, the positions of pedicle screws were classified using the Gertzbein and Robbins criteria [ 12 ]. Grade A represents an intra-pedicular screw without breaching the cortical layer of the pedicle. Grade B refers to a screw that breaches the cortical layer of the pedicle but does not exceed it laterally by more than 2 mm. Grades C and D indicate penetration of less than 4 mm and 6 mm, respectively (indicated by arrows). Grade E is assigned to screws (indicated by arrows) that either do not pass through the pedicle or, at any point in their intended intra-pedicular course, breach the cortical layer of the pedicle in any direction by more than 6 mm. Proximal FJV was assessed according to the violation grade proposed by Babu et al. [ 13 ]. The grading system for violations was as follows: Grade 0 represented pedicle screws that did not encroach on the facet joint. Grade 1 defined pedicle screws that violated the facet joint surface by ≤ 1 mm. Grade 2 represented pedicle screws that clearly violated the facet joint. The secondary outcomes include radiation time and dose (duration of radiation exposure and amount of radiation administered during the surgery), duration of surgery (total time required for the surgical procedure), estimated blood loss (EBL, an estimation of the amount of blood lost during surgery), and surgical revision (instances where revision surgery was required due to complications or issues with the initial pedicle screw placement).

The minimally important difference (MID) is the smallest amount of improvement in a treatment outcome that patients would recognize as important. For Proximal FJV, a lower grade is better, and the MID is Grade A. Regarding intra-pedicular accuracy, the MID of Grade 0 represents perfect intra-pedicular localization with no cortical breach. Any deviation from perfect intra-pedicular localization (i.e., any grade higher than 0) would be considered clinically meaningful. As for all secondary outcomes, there are no articles discussing the MID for them, but lower values are considered better.

Two investigators independently selected articles based on the criteria described above. The full text was scanned to determine whether the articles met the inclusion criteria. Disagreements were resolved through discussion until a consensus was reached. If no consensus was reached, a third investigator was consulted.

In this study, our primary objectives included assessing the accuracy of percutaneous pedicle screw placement, proximal FJV, radiation exposure, duration of surgery, EBL, and the necessity for surgical revision. We selected these outcomes based on their clinical relevance to spinal surgery and their alignment with the specific research questions we aimed to address. However, we must acknowledge that the manuscript does not include several outcomes that were initially planned in the study protocol, such as the length of hospital stay, VAS for leg pain and back pain, and the Oswestry Disability Index. The decision to exclude these outcomes was made after careful consideration of data availability and their alignment with the primary research objectives. The omission of these outcomes does not compromise the validity of our findings concerning the primary objectives mentioned above. We believe that focusing on these specific outcomes provided a more focused and in-depth analysis of the key aspects of our study.

Risk of bias and quality of evidence

The methodological quality of the included studies was evaluated using the Cochrane Risk of Bias Tool for randomized controlled trials (RCTs) and the Risk of Bias in Non-Randomized Studies—of Interventions (ROBINS-I) Tool for non-RCTs. Two researchers conducted the assessments independently. In instances of disagreement, a third researcher made the final decision. The ROBINS-I tool encompasses an evaluation of bias risks related to confounding factors (such as insufficient information on the number of operation levels, baseline health status, surgeon experience, patient selection criteria, or center-specific factors), participant selection, intervention classification, deviations from the intended intervention, missing data, outcome measurement, and the selection of reported results [ 14 ].

The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the overall quality and strength of available evidence. With the use of this approach, evidence is classified as “very low,” “low,” “moderate,” or “high” quality. Evidence from RCTs receives a default grade of “high” quality but may be downgraded based on prespecified criteria. Reasons for downgrading include risk of bias (assessed through the Cochrane Risk of Bias tool and ROBIN-I tool), inconsistency (substantial unexplained interstudy heterogeneity; I 2  ≥ 50%, P  < 0.10), indirectness (presence of factors that limited the generalizability of the results), imprecision (the 95% CI for effect estimates were wide or crossed a minimally important difference for benefit or harm), and publication bias (significant evidence of small-study effects).

Subgroup analysis

We conducted subgroup analyses if there were 2 or more studies in a given subgroup and performed tests of interaction to establish whether the subgroups differed significantly from one another. We assessed the credibility of significant subgroup effects ( P  < 0.05) using previously suggested criteria. Subgroup analyses was performed for type of surgery, type of robot system and study design.

Statistical analysis

We assess standard mean difference (SMD) with 95% confidence interval (CI) for continuous outcomes and risk ratio (RR) with 95% CI for dichotomous outcomes. Random models were used for all analyses and not to rely on (arbitrary) cut of values for heterogeneity. The rationale for this is that studies on these patient populations cannot be assumed to have one true mean estimate. Statistical heterogeneity was assessed with the Q-test and the I 2 statistic. I 2 values of 25%, 50%, and 75% were considered to indicate low, moderate, and high heterogeneity, respectively [ 15 ]. If more than 10 studies were available for a particular comparison, we used funnel plots to determine publication bias. Sensitivity analysis using the trim and fill method is employed to assess the stability of the meta-analysis results [ 16 ]. If there is little difference in the funnel plot before and after the trim and fill method, it indicates that the results are stable and highly reliable. And missing values were handled, and imputation methods (mean SD from similar studies) was used.

Data were analyzed with the open-source, meta-analysis software OpenMeta-Analyst, which uses R as the underlying statistical engine [ 17 ]. All figures were generated using RStudio.

Search results and trial characteristics

Title and abstract literature review yielded 539 articles, of which 72 met the inclusion criteria for full text review (Fig.  1 ). References of 7 systematic reviews found through our online search were also reviewed for relevant articles. A final 21 articles met the inclusion criteria for quantitative analysis. Among them, there were 2 randomized controlled trials (RCTs) [ 18 , 19 ] and 19 CSs [ 8 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Among the twenty-one studies, six of included studies used Renaissance™ system [ 20 , 21 , 26 , 27 , 30 , 32 ], eleven of included studies used TiRobot system [ 18 , 19 , 22 , 23 , 24 , 25 , 28 , 34 , 35 , 36 , 37 ], three of included studies used ROSA™ system [ 8 , 31 , 33 ] and one of included studies used Mazor X Robot system [ 29 ]. In terms of surgical type, five of included studies applied the robot system in TLIF surgery [ 20 , 22 , 23 , 24 , 30 ] and sixteen of included studies used the robot system in MIS-TLIF surgery [ 8 , 18 , 19 , 21 , 25 , 26 , 27 , 28 , 29 , 31 , 32 , 33 , 34 , 35 , 36 , 37 ]. Characteristics of included studies are summarized in Table  2 .

figure 1

Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) flow chart of the selection process. (The PRISMA 2020 statement: an updated guideline for reporting systematic reviews) [ 38 ]

Primary outcome

The accuracy of pedicle screw placement.

The comparison of the accuracy of pedicle screw placement between RA-and FG-TLIF according to Gertzbein and Robbins criteria in fourteen CSs. If any portion of the screw was ≤ 3 mm outside the pedicle (Grade A + B), we categorized them as “clinically acceptable” accuracy. And the portion of the screw was not deviation (Grade A), we categorized them as “perfect” accuracy.

The “clinically acceptable” accuracy

Low-quality evidence from fourteen CSs [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 28 , 31 , 32 , 34 , 35 , 36 , 37 ] (Table  3 ), reported a significant difference in “clinically acceptable” accuracy between RA- and FG-TLIF, and RA had 1.03-folds higher “clinically acceptable” accuracy than FG (RR: 1.0382, 95% CI: 1.0273–1.0493, z = 6.96, I 2  = 9%, p  < 0.0001, Fig.  2 ). The funnel plot demonstrates a mostly symmetrical distribution, and minimal changes are observed after applying the trim-and-fill method. This indicates a high level of confidence in the result (Fig.  3 ).

figure 2

Pooled Analysis of Pedicle Screw Insertion “clinically acceptable” Accuracy. a Subgroup of surgical type. b Subgroup of robotic type

figure 3

Funnel plot of CSs comparing the “clinically acceptable” accuracy of pedicle screw placement between RA and FG TLIF (left). And the shape of funnel plot after trim-and-fill method (right). No funnel plot of RCTs has been included as there were fewer than 10 RCTs

Subgroup analysis based on surgical type showed that RA had higher “clinically acceptable” accuracy than FG both in TLIF (RR: 1.04, 95% CI: 1.02–1.06, I 2  = 0%, p  < 0.05, Fig.  2 a) and MIS-TLIF (RR: 1.03, 95% CI: 1.02–1.04, I 2  = 32%, p  < 0.05, Fig.  2 a).

Subgroup analysis based on robotic type showed that Renaissance™ system, TiRobot and ROSA ™ system assisted TLIF have higher “clinically acceptable” accuracy than FG-TLIF (Fig.  2 b).

The “perfect” accuracy

Low-quality evidence from fourteen CSs [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 28 , 31 , 32 , 34 , 35 , 36 , 37 ] (Table  3 ), reported a significant difference in “perfect” accuracy between RA and FG TLIF. RA exhibited 1.12-folds higher “perfect” accuracy than FG group, with high evidence of heterogeneity (RR: 1.1167, 95% CI: 1.0726–1.1626, z = 5.37, I 2  = 75%, p  < 0.0001, Fig.  4 ). The funnel plot demonstrates a mostly symmetrical distribution, and minimal changes are observed after applying the trim-and-fill method. This indicates a high level of confidence in the result (Fig.  5 ).

figure 4

Pooled Analysis of Pedicle Screw Insertion “perfect” Accuracy. a Subgroup of surgical type. b Subgroup of robotic type

figure 5

Funnel plot of CSs comparing the “perfect” accuracy of pedicle screw placement between RA and FG TLIF (top). And the shape of funnel plot after trim-and-fill method (bottom)

Subgroup analysis based on surgical type showed that RA had higher “perfect acceptable” accuracy than FG in both TLIF (RR: 1.08, 95% CI: 1.04–1.12, I 2  = 0%, p  < 0.05, Fig.  3 a) and MIS-TLIF (RR: 1.13, 95% CI: 1.07–1.19, I 2  = 82%, p  < 0.05, Fig.  3 a). Subgroup analysis based on robotic type indicated that Renaissance™ system, TiRobot and ROSA ™ system assisted TLIF have higher “perfect acceptable” accuracy than FG-TLIF (Fig.  3 b).

A RCT reported the accuracy of pedicle screw placement with the following result [ 28 ]. Among the 92 pedicle screws in the RA group, 87 were Grade A, and 5 were Grade B. Among the 100 pedicle screws in the FG group, 85 were Grade A, and 15 were Grade B. The superiority of Grade A screws was observed in the robot-assisted MIS-TLIF group.

Proximal facet joint violation

Low-quality evidence from five CSs [ 21 , 22 , 23 , 35 , 36 ], reported proximal FJV assessed through CT scans. The results suggest that the patients who underwent RA pedicle screw placement had 74% fewer proximal FJV than the FG group (RR: 0.2606, 95%CI: 0.2063- 0.3293, z = -11.27, I 2  = 3%, p  < 0.0001) (Fig.  6 ).

figure 6

Pooled Analysis of Proximal Facet Joint Violation

Secondary outcome

Duration of surgery.

Very low-quality evidence from seventeen CSs [ 8 , 20 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 ] and two RCTs [ 18 , 19 ] (Table  3 ), reported the duration of time, as shown in Fig.  7 . The results of CSs suggest that there is no significant difference between RA and FG group, with high evidence of heterogeneity (SMD: 0.1111, 95%CI: -0.391–0.6131, z = 0.43, I 2  = 93%, p  = 0.6646). The funnel plot demonstrates a symmetrical distribution, and the funnel plot shows minimal changes after trim-and-fill method, indicating this result with a high level of confidence (Fig.  8 ).

figure 7

Pooled Analysis of Duration of Surgery. a Subgroup of surgical type (Cohort study). b Subgroup of robotic type (Cohort study). c Pooled Analysis of RCT

figure 8

Funnel plot of CSs comparing the duration of surgery between RA-and FG-TLIF (top). And the shape of funnel plot after trim-and-fill method (bottom). No funnel plot of RCTs has been included as there were fewer than 10 RCTs

Subgroup analysis of surgical type showed that the patients who underwent RA pedicle screw placement need more surgery time than FG group in TLIF surgery (Fig.  7 a). However, the duration of surgery did not show a difference between RA and FG group in MIS-TILF surgery (Fig.  7 a).

According to subgroup analysis of robotic types, no robotic system outperforms the FG-TLIF in terms of duration of surgery (Fig.  7 b).

And the subgroup analysis of study types [ 18 , 19 ] showed that the patients who underwent RA pedicle screw placement need more surgery time (3.72 × SD minutes) than FG group (SMD: 3.7213, 95%CI: 3.0756–4.3669, z = 11.30, I 2  = 0%, p  < 0.0001, Fig.  7 c).

Estimated blood loss

Low-quality evidence from sixteen CSs [ 8 , 20 , 22 , 23 , 24 , 25 , 26 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 ] and two RCTs [ 18 , 19 ] (Table  3 ), reported the estimated blood loss, as shown in Fig.  9 . The results of CSs suggest that the patients who underwent RA pedicle screw placement had fewer estimated blood loss than FG group, with high evidence of heterogeneity (SMD: -1.9151, 95%CI: -3.1265–0.7036, z = -3.10, I 2  = 98%, p  = 0.0019). The funnel plot demonstrates a symmetrical distribution, and the funnel plot shows minimal changes after trim-and-fill method, indicating this result is reliable (Fig.  10 ).

figure 9

Pooled Analysis of Estimated Blood Loss. a Subgroup of surgical type. b Subgroup of robotic type. c Pooled Analysis of RCT

figure 10

Funnel plot of CSs comparing the estimated blood loss between RA-and FG-TLIF (top). And the shape of funnel plot after trim-and-fill method (bottom). No funnel plot of RCTs has been included as there were fewer than 10 RCTs

Subgroup analysis of surgical type showed that the patients who underwent RA pedicle screw placement with fewer EBL than FG group both in TLIF and MIS-TLIF surgery (Fig.  9 a). And Subgroup analysis of robotic type showed that the patients who underwent Renaissance™ system and TiRobot assisted pedicle screw placement with fewer EBL both in TLIF and MIS-TLIF surgery, however, the Mazor X Robot and ROSA™ do not demonstrate this advantage (Fig.  9 b).

And the results of RCTs [ 18 , 19 ] suggest that the patients who underwent RA pedicle screw placement had fewer estimated blood loss than FG group, with high evidence of heterogeneity (SMD: -5.9010, 95%CI: -8.7238–3.0782, z = -4.10, I 2  = 88%, p  < 0.0001, Fig.  9 c).

Radiation exposure

Radiation time.

Very low-quality evidence from seven CSs [ 22 , 23 , 24 , 28 , 32 , 34 , 37 ] (Table  3 ), reported the radiation time, as shown in Fig.  11 . The results of CSs suggest that there is no significant difference in radiation time between RA and FG group, with high evidence of heterogeneity (SMD: -0.5256, 95%CI: -1.4357–0.3845, z = -1.13, I 2  = 98%, p  = 0.2576).

figure 11

Pooled Analysis of Radiation Time

Subgroup analysis of surgical type showed that the patients who underwent RA pedicle screw placement with fewer radiation exposure time in TLIF surgery, however, RA pedicle screw placement does not demonstrate this advantage when compared to FG pedicle screw placement in MIS-TLIF surgery (Fig.  11 ).

Radiation dose

Very low-Grade quality evidence from seven CSs [ 22 , 23 , 24 , 29 , 32 , 34 , 37 ] (Table  3 ), reported the radiation dose, as shown in Fig.  12 . The results of CSs suggest that the patients who underwent RA pedicle screw placement had fewer radiation dose than FG group, with high evidence of heterogeneity (SMD: -2.2682, 95%CI: -3.1953–1.3411, z = -4.79, I 2  = 94%, p  < 0.0001).

figure 12

Pooled Analysis of Radiation Dose

Subgroup analysis of surgical type and robotic type showed that the patients who underwent RA pedicle screw placement with fewer radiation exposure dose both in TLIF and MIS-TLIF surgery.

Surgical revision

Low-quality evidence from four CSs [ 8 , 22 , 30 , 32 ] and one RCT [ 18 ] (Table  3 ), reported the number of surgical revisions, as shown in Fig.  13 . The results of CSs suggest that there is no significant difference in the number of surgical revisions between RA and FG group (RR: 0.4087, 95% CI 0.1592–1.0495, z = -1.86, I 2  = 0%, p  = 0.0629). However, the RCT [ 18 ] reported that the number of surgical revisions of RA pedicle screw placement is lower than FG pedicle screw placement.

figure 13

Pooled Analysis of Surgical Revision

Risk of bias

The Cochrane risk of bias tool was adopted evaluate the mythological quality of two RCTs, and the results were presented in Table  4 . The quality of two RCTs was limited predominantly by lack of blinding, given the nature of clinical study. Regarding the random sequence generation and allocation concealment, two studies [ 18 , 19 ] were low risk. In terms of blinding of outcome assessment, no information was reported to affect the outcomes because of the deviations [ 19 ]. With respect to the incomplete outcome data, two studies [ 18 , 19 ] were not mentioned, thus these two studies were at unclear risks. As for selective reporting, all the RCTs were at low risk, because there is complete data and results reported with no selection. Other bias was not mentioned in these two RCTs, thus the risk of bias was unclear risks.

The ROBINS-I was used to assess the risk of bias for four prospective cohort studies [ 23 , 24 , 26 , 35 ] and fifteen retrospective cohort studies [ 8 , 20 , 21 , 22 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 37 ] (Table  5 ), and detail of reasons for bias are documented in Supplemental 2.

Main findings and interpretation of the results

Lumbar degenerative diseases, such as spinal stenosis, disc herniation and spondylolisthesis, represent the primary causes of low back and leg pain in elderly patients [ 39 ]. When conservative treatments prove ineffective, surgical intervention becomes an inevitable option, and the choice of surgical methods varies significantly based on individual patient characteristics and their specific symptoms [ 40 ]. The conventional PLIF necessitates extensive soft tissue dissection, such as paraspinal muscles, resulting in surgical trauma and an increased risk of recurring postoperative pain [ 41 ]. This significantly impairs the postoperative quality of life for patients [ 42 ]. With the widespread promotion and application of minimally invasive techniques, there has been an increasing number of surgical options for lumbar degenerative diseases. TLIF, a technique that combines interbody fusion with pedicle screw fixation, has addressed several issues encountered in the traditional PLIF. TLIF utilizes a tube to access the intervertebral space through the intervertebral foramen, gradually expanding the muscle interval to avoid extensive soft tissue dissection. This technique effectively reduces damage to the paraspinal muscles and significantly lowers the risk of neurological and vascular injuries [ 43 , 44 ]. However, the placement of channels for screw insertion and percutaneous pedicle screw fixation in TLIF requires fluoroscopic guidance, leading to extended surgical duration and increased radiation exposure compared to PLIF. In recent years, remarkable progress has been made in the clinical utilization of intelligent and digital technologies in the field of orthopedic surgery. Robot-assisted spinal surgery offers the benefits of minimally invasive procedures, enhanced precision, and reduced trauma. Through meticulous planning of optimal entry points, angles, and depths, the safety, accuracy, and precision of surgical procedures, including screw placement, have undergone significant enhancements [ 45 , 46 ]. However, RA-TLIF has a steep learning curve compared to traditional FG-TLIF, requiring additional time and money. Hence, clinicians should thoroughly contemplate whether utilizing RA technology for TLIF is a more fitting choice.

The evaluation of RA pedicle screw placement primarily focuses on the accuracy of screw insertion, followed by factors such as radiation exposure, surgical duration, and blood loss. While most studies have demonstrated positive results for the RA screw placement compared to the free-hand or FG screw placement [ 47 ], there are still varying opinions in some studies. Some studies have indicated that in scenarios where anatomical structures are adequately visualized, RA screw placement may not necessarily provide a substantial accuracy advantage over traditional FG screw placement [ 20 , 48 ]. Additionally, some studies indicating that RA may decrease accuracy of screw placement [ 49 ]. The debate of RA screw placement may stem from factors such as preoperative planning, image quality, and intraoperative manipulation. The automatic calculations for robot parameters still require surgeon verification, fine-tuning, or manual planning. The efficiency and accuracy of planning are closely related to image calibration and image mode selection. Currently, the automatic combination of 2D and 3D multimodal images is possible but may require more time-consuming. The design of screw placement still relies primarily on manual assessment, lacking self-planning and validation that incorporate motion and individual patient conditions. Therefore, whether RA-TLIF offers advantages in terms of accuracy, surgical time, and intraoperative blood loss over traditional FG-TLIF remains inconclusive until evidence from systematic reviews and meta-analyses becomes available.

Screw placement accuracy

For the assessment of screw placement accuracy, the Gertzbein and Robbins criteria are commonly used [ 12 ]. Based on previous literature categorizing the accuracy of screw placement, this study considers the combination of Grade A + Grade B as "clinically acceptable" accuracy of pedicle screw placement, while Grade A is categorized as "perfect" accuracy of pedicle screw placement. We conducted a meta-analysis with pooled data from fourteen CSs [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 28 , 31 , 32 , 34 , 35 , 36 , 37 ] that included 1432 patients and 5466 cranial pedicle screws to explore whether RA-TLIF is superior to FG-TLIF in terms of “clinically acceptable” and “perfect” accuracy of pedicle screw placement. We believe that this study is the first meta-analysis to systematically compare the accuracy of pedicle screw placement between RA and FG pedicle screw placement in TLIF; however, the quality of evidence is low. The meta-analysis demonstrated that RA insertion was associated with substantially higher accuracy of pedicle screw placement than conventional FG screw insertion in TLIF. Furthermore, the pooled results of subgroup analysis suggest that RA pedicle screw placement demonstrated greater accuracy than FG in both TLIF and MIS-TLIF. In terms of robotic type, the Renaissance™ system, TiRobot, and ROSA™ system assisted TLIF have higher accuracy than FG-TLIF.

A previous study conducted by Molliqaj et al. [ 50 ] retrospectively analyzed the comparison between RA and FG screw placement in thoracolumbar fractures. The study found that RA screw placement had a higher accuracy rate compared to FG screw placement. Macke et al. [ 51 ] demonstrated the application of RA screw placement in the treatment of idiopathic scoliosis, and found a screw placement accuracy rate of 99.04% for RA placement, superior to FG placement (90.74%). Serval studies also indicate that in spinal surgeries, RA screw placement achieves significantly higher accuracy rates than FG screw placement [ 46 , 52 , 53 ]. However, currently, there is still a lack of evidence to suggest that RA has a superiority over traditional FG in terms of screw placement accuracy in TLIF. Generally speaking, due to the specific anatomical characteristics of each patient, RA surgery requires preoperative detailed 3D planning. Through above, the surgeon gains a comprehensive understanding of the surgical anatomical structures and reduces the likelihood of intraoperative complications. Preoperative planning also allows for optimization of implant size and trajectory based on the specific pedicle anatomy of patients. The robot system can simulate ideal screw trajectories based on individual anatomical differences and accurately reproducing these simulations during surgery. This is the primary reason why RA-TLIF.

This meta-analysis revealed that RA screw placement in TLIF can indeed reduce proximal FJV compared to FG-PLIF [ 21 , 22 , 23 , 35 , 36 ] (RR: 0.2606, 95%CI: 0.2063- 0.3293). The quality of evidence for proximal facet joint violation is low.

The accuracy of screw placement is also related to the proximal FJV [ 54 ], which has been regarded as an independent risk factor for ASD after spinal fusion [ 55 , 56 ]. Sakaura et al. [ 57 ] conducted a comparative study, comparing cortical bone trajectory and traditional trajectory insertion techniques. They reported that the use of cortical bone trajectory may potentially decrease the occurrence of radiographic and systemic spinal degeneration by preserving the proximal facet joints. Levin et al. [ 58 ] pointed out that the FJV was associated with increased reoperation rates and reduced improvement in quality of life. Hyun et al. [ 59 ] conducted a prospective RCT and found no significant difference in the incidence of FJV between RA and FG insertion methods (0.00% vs. 0.71%). Similarly, Archavlis et al. [ 60 ] revealed that the occurrence of FJV in the RA group was similar to that in the FG group (5% vs. 6%). FG pedicle screw placement remains the most used technique for lumbar fusion. Meanwhile, RA screw placement has emerged as a novel minimally invasive technique, which has gradually gained acceptance for reducing screw misplacement rates and enhancing insertion safety. However, contradictory results exist regarding the incidence of FJV between FG-and RA-TLIF. We believe that the use of RA enables precise positioning, ensuring optimal screw placement within the target area of each pedicle. This minimizes the disturbance caused by pedicle screws to the adjacent proximal segment structures, reduces stress on the adjacent vertebrae, improves the biomechanical environment of the segmental structure, and ultimately decreases the probability of pseudoarthrosis and ASD.

Perioperative indicators

According to GRADE assessment of included studies, the quality of evidence for surgery duration is very low. Surgical duration and intraoperative blood loss are perioperative indicators directly related to screw placement accuracy. Currently, there is no evidence suggesting that RA-TLIF can reduce surgical time and intraoperative blood loss. The results of this meta-analysis revealed that there was no significant difference in surgical time between the two groups [ 8 , 20 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 ], and the funnel plot remained unchanged after applying the trim-and-fill method, indicating result stability. However, results of RCTs [ 18 , 19 ] showed that RA had a longer surgical time compared to the FG group. Although RCTs have higher methodological quality and evidence levels than CSs, we feel that this analysis contained a greater number of moderate-quality CSs, while the number of included RCTs was limited and lacked blinding. As a result, we have greater confidence in the CS results, which show that there is no significant difference in surgical time between RA-TLIF and FG-TLIF. This may be attributed to the higher proficiency level in manual percutaneous screw placement in MIS surgery. It is speculated that as proficiency in robot usage increases, this time difference may become more prominent. Furthermore, the pooled results of subgroup analysis show that RA has a benefit over FG only in open TLIF surgery in terms of shorting surgical time, but not in MIS-TLIF surgery (SMD: 0.57, 95%CI: 0.15–1). This could be because the field of view in open TLIF surgery is greater and the operation of the surgical robot is easier, resulting in a shorter operation time than in FG-MISTLIF.

Regarding EBL, the quality of evidence for surgery duration is low. The pooled results of this study indicated that both CSs [ 8 , 20 , 22 , 23 , 24 , 25 , 26 , 28 , 29 , 30 , 32 , 33 , 34 , 35 , 36 , 37 ] and RCTs [ 18 , 19 ] showed lower EBL with the application of RA in TLIF compared to FG. Furthermore, the surgical type and robotic type subgroups all revealed that RA screw placement accuracy can lower EBL when compared to FG screw placement accuracy. This is primarily attributed to the more accurate screw placement in RA surgeries, where the planned screw trajectory may reduce tension on the pedicle screw insertion, thus decreasing stress on the pedicle and potentially reducing tension and damage to surrounding soft tissues, such as muscles and skin.

Intraoperative radiation exposure caused by fluoroscopy is another concern to consider in TLIF [ 61 , 62 ]. This study found no significant difference in radiation exposure time between the RA-TLIF and FG-TLIF [ 22 , 23 , 24 , 28 , 32 , 34 , 37 ], and the evidence for them are low quality. Subgroup analysis showed that RA pedicle screw placement is associated with a reduction in radiation exposure time compared to FG techniques. This suggests that the use of robotics is particularly effective in decreasing radiation exposure in open TLIF procedures. In MIS-TLIF, there is no significant difference in radiation exposure time between RA and FG techniques. This implies that, in the context of MIS-TLIF, both RA and FG may result in similar levels of radiation exposure. However, the intraoperative radiation dose in the RA group was significantly lower than in the FG group [ 8 , 18 , 19 , 22 , 30 , 32 ]. And subgroup analysis has the same results.

Most studies suggest that one of the advantages of surgical robots is their ability to minimize intraoperative radiation exposure. Roser et al. [ 63 ] compared the radiation doses between RA and FG techniques and found that RA has lower doses compared to the FG group. However, Ringel et al. [ 49 ] reported no significant difference in intraoperative radiation doses between RA an FG. Schizas et al. [ 64 ] reported similar radiation times between the two groups. Based on our results of RA surgeries, there is contradictory in reducing radiation time, and the analysis indicates that the experience of the surgeon is important factors in determining radiation exposure. We believe that while RA can reduce radiation exposure in the operating room, patients often require preoperative CT scans for surgical planning, and these studies may have included the radiation time from preoperative CT scans. FG techniques rely on repeated intraoperative fluoroscopy, while RA techniques rely on the patient's preoperative 3D CT scans and preoperative planning. This is the main reason for the lack of significant difference in radiation exposure time between the two techniques.

It is important to note that the absence of a significant difference in the number of surgical revisions due to misplacement between the RA and FG screw placement in the study suggests that both techniques, when properly performed, have a similar rate of accuracy in pedicle screw placement [ 8 , 18 , 22 , 30 , 32 ]. However, the quality of evidence for surgical revision outcomes in the study is low, which affect the confidence in the results related to surgical revisions.

Surgical revision is necessary in cases of severe screw misplacement or persistent radicular pain following the initial surgery. This is because FG techniques, being the gold standard for implantation, are performed by experienced clinicians who can effectively avoid severe misplacements and postoperative complications, similar to the RA-TLIF. Nevertheless, we believe that with the advancement of modern spine surgery, the increasing complexity of spinal disorders poses higher demands on minimally invasive techniques. Robotic assistance, combined with artificial intelligence, can alleviate factors such as insufficient clinical experience, enabling more precise and accurate operations. Considering the diverse and complex clinical conditions and the need for different indications, the development of robotic technology is expected to become more refined and systematic, providing better service in the clinic.


Several limitations should be interpreted in this meta-analysis. The main limitation of this study is that there were too few relevant RCTs devoted to the evaluation of the difference of RA-TLIF and FG-TLIF. Thus, we did not perform the assessment of publication bias in some outcome, such as proximal facet joint violation, radiation exposure and surgical revision. Another limitation is that our study included only two RCTs, four prospective CSs and fifteen retrospective CSs. A meta-analysis of such data will lead to less powerful results compared to study obtained purely from RCTs. This difficulty primarily arises from the challenges associated with executing double-blind, randomized selection of surgical techniques in a clinical setting. Next, a limitation of this systematic review is that the general quality of the available RCTs was not high. Because studies could not blind the participants because they had the right to know about the surgery interventions., blinding of personnel and participants was impossible in practice. Investigators in most of the included studies did not describe clearly whether the outcome assessments were blinded. Moreover, our findings are limited by the heterogeneity of the included studies, therefore, the reliability of the results may be insufficient. Then, an important limitation of this study is that not all initially planned outcomes were investigated. While the primary objectives were rigorously addressed, the decision to omit certain planned outcomes introduces a potential source of bias and limits the overall comprehensiveness of our analysis. Finally, while we took rigorous measures to ensure the systematic and well-documented execution of all research procedures, data collection, and data analysis, we acknowledge that the retrospective nature of protocol registration is a serious limitation. We want to emphasize that this retrospective registration does not compromise the quality, validity, or integrity of the research findings presented in this manuscript. However, we recognize its potential impact on the perception of study transparency and pre-specification.

Implications for future research

The results of this systematic review suggest that RA-TLIF may have certain advantages over traditional FG-TLIF. However, additional RCTs and CSs are needed to confirm these findings and provide a more comprehensive understanding of the benefits and drawbacks of each approach. Furthermore, large-scale, multicenter studies could provide more robust evidence by increasing the sample size and diversity of patient populations. Collaborative efforts can help validate the findings and enhance the generalizability of the results.

Further research in this field should focus on the following aspects. Future trials should pay attention to this area, expand the sample size, and adopt more rigorous RCT designs including the assessment of adverse effects, to incorporate additional studies in the meta-analysis. Furthermore, a critical aspect of future research should involve a comprehensive cost-effectiveness analysis comparing RA-TLIF with FG-TLIF. This would provide healthcare decision-makers with valuable information regarding the economic implications of adopting robotic technology. Last, Investigating the learning curve for surgeons adopting RA-TLIF is important. Future research should assess how surgeon experience and training impact patient outcomes to ensure safe and effective implementation of this technology.

In TLIF, RA technology demonstrates more accurate placement of pedicle screws compared to FG, offering advantages in protecting adjacent facet joints and reducing intraoperative radiation dosage and blood loss. However, due to longer preoperative preparation time, the surgical duration and radiation time of RA is comparable to FG techniques. Currently, FG screw placement continues to be the predominant technique, and surgeons have greater proficiency in its application. Thus, the integration of RA into TLIF surgery may not be an optimal choice.

Availability of data and materials

All data generated or analyzed during this study are included in this published article or are available from the corresponding author on reasonable request.

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JBG and KTY designed the systematic review. JBG and NNF drafted the protocol and KTY revised the manuscript. GJB and NNF will independently screen the potential studies, extract data, assess the risk of bias and finish data synthesis. GJB and KTY will arbitrate any disagreements during the review. Xing Yu revised English language of the manuscript. All authors approved the publication of the protocol. JBG is the first author and KTY is corresponding author.

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Guan, J., Feng, N., Yu, X. et al. Comparison of robot-assisted versus fluoroscopy-guided transforaminal lumbar interbody fusion (TLIF) for lumbar degenerative diseases: a systematic review and meta-analysis of randomized controlled trails and cohort studies. Syst Rev 13 , 170 (2024). https://doi.org/10.1186/s13643-024-02600-6

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Diversified cover crops and no-till enhanced soil total nitrogen and arbuscular mycorrhizal fungi diversity: a case study from the karst area of southwest china.

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1. Introduction

2. materials and methods, 2.1. experimental sites, 2.2. experimental design, 2.3. soil sampling, 2.4. soil analyses, 2.5. plant yield, 2.6. dna extraction and pcr amplification, 2.7. illumina novaseq sequencing, 2.8. bioinformatics analysis, 2.9. statistical analysis, 3.1. soil nutrient status, 3.2. analysis of the amf community composition in the soils with the different management practices, 3.3. soil microbiological properties, 3.4. plant yield, 3.5. the relationship between the amf and the soil properties, 4. discussion, 4.1. effects of tillage methods and different forage mixture combinations on soil nutrients, 4.2. effects of tillage methods and different forage mixture combinations on soil amf, 4.3. effects of tillage methods and different forage mixture combinations on soil enzymes and their microbial properties, 4.4. effects of tillage methods and different forage mixture combinations on plant yield, 4.5. correlation between soil enzyme activity and amf, 5. conclusions, supplementary materials, author contributions, data availability statement, acknowledgments, conflicts of interest.

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Click here to enlarge figure

TreatmentSOM (g kg )TN (g kg )TP (g kg )AN (mg kg )AP (mg kg )pH
GlomeromycotaGlomeromycetesArchaeosporalesArchaeosporaceaeArchaeosporaArchaeospora VTX00005
Archaeospora VTX00245
AcaulosporaceaeAcaulosporaAcaulospora VTX00030
Acaulospora VTX00037
DiversisporalesDiversisporaceaeDiversisporaDiversispora VTX00062
Diversispora VTX00054
GlomeralesGlomeraceaeGlomusGlomus VTX00150
Glomus VTX00280
Glomus VTX00114
Glomus VTX00143
Glomus VTX00125
Glomus VTX00222
Glomus VTX00113
Glomus VTX00310
Glomus VTX00309
Glomus VTX00195
Glomus VTX00092
Glomus VTX00248
Glomus VTX00056
Glomus VTX00278
Glomus VTX00057
Glomus VTX00193
Glomus VTX00279
Glomus VTX00307
Glomus VTX00333
Glomus VTX00063
ParaglomeralesParaglomeraceaeParaglomusParaglomus VTX00337
(U g )
(U g )
(U g )
Spore Density
(g soil )
(mg g )
(mg g )
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Share and Cite

Tian, L.; Wang, T.; Cui, S.; Li, Y.; Gui, W.; Yang, F.; Chen, J.; Dong, R.; Gu, X.; Zhao, X.; et al. Diversified Cover Crops and No-Till Enhanced Soil Total Nitrogen and Arbuscular Mycorrhizal Fungi Diversity: A Case Study from the Karst Area of Southwest China. Agriculture 2024 , 14 , 1103. https://doi.org/10.3390/agriculture14071103

Tian L, Wang T, Cui S, Li Y, Gui W, Yang F, Chen J, Dong R, Gu X, Zhao X, et al. Diversified Cover Crops and No-Till Enhanced Soil Total Nitrogen and Arbuscular Mycorrhizal Fungi Diversity: A Case Study from the Karst Area of Southwest China. Agriculture . 2024; 14(7):1103. https://doi.org/10.3390/agriculture14071103

Tian, Lihua, Tao Wang, Song Cui, Yuan Li, Weiyang Gui, Feng Yang, Jihui Chen, Rui Dong, Xinyao Gu, Xuechun Zhao, and et al. 2024. "Diversified Cover Crops and No-Till Enhanced Soil Total Nitrogen and Arbuscular Mycorrhizal Fungi Diversity: A Case Study from the Karst Area of Southwest China" Agriculture 14, no. 7: 1103. https://doi.org/10.3390/agriculture14071103

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