case designs - Case Designs Reports that cover the...

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1 © 2006 Case Designs Reports that cover the management of a single patient or a series of patients
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Evidence-based © 2006 2 Three types of case designs 1. Case Report An article that describes the clinical course of 1 or 2 patients Typically consist of complaints, examination findings, diagnosis, treatment, and outcome Case reports often provide early evidence of new diseases, treatments, or adverse effects No hypothesis, data analysis, or generalizable conclusion is possible
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Evidence-based © 2006 3 Three types of case designs (cont.) 2. Case Series More than 2 case reports in a single paper 2. Single-subject time series design A type of case report that tracks a patient’s condition using multiple sequential assessments during a treatment phase and a phase when they are not being treated
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Evidence-based © 2006 4 The purposes and limitations of case reports Purposes Detect rare conditions Educational value Learn how other doctors manage certain cases Generate hypotheses Limitations Susceptible to many biases Unable to test hypotheses Does not determine the effectiveness of an intervention Unable to generalize results to other patients or practices
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Evidence-based © 2006 5 Preparation of case reports Does not typically require approval from an Institutional Review Board However, patient confidentiality should be respected Personal information that might identify the patient should not be used Patient photographs require written consent prior to submitting the report for publication
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Evidence-based © 2006 6 Reasons case reports are returned to authors for revision Claims of cause-and-effect relationships between interventions and outcomes Lack of information about the reliability and validity of measurements Lack of detail about the examination and the intervention Lack of detail about decision making
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Evidence-based © 2006 7 The evidence-based case report Designed to illustrate the process of locating and applying evidence to clinical circumstances How evidence can be applied during the various phases of patient care Informative even when little or no high- quality evidence is available They do not report new findings
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Evidence-based © 2006 8 Meta-analyses of case reports or case series Occasionally seen in the literature Sometimes they can draw important new conclusions from the literature Limited statistical analyses may be done e.g., totals, means, proportions, correlation Conclusions may be proven wrong after more definitive research has been done
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Evidence-based © 2006 9 Single-subject time series designs (SSTSDs) A study that involves a single patient Repeated measures are taken while an intervention is applied and withdrawn The objective is to observe differences in the outcome measures during each phase Improvement during the intervention phase may mean that the treatment is effective for that patient
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Evidence-based © 2006 10 SSTSDs (cont.)
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case designs - Case Designs Reports that cover the...

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