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Case Study Methods and Examples

By Janet Salmons, PhD Manager, Sage Research Methods Community

What is Case Study Methodology ?

Case studies in research are both unique and uniquely confusing. The term case study is confusing because the same term is used multiple ways. The term can refer to the methodology, that is, a system of frameworks used to design a study, or the methods used to conduct it. Or, case study can refer to a type of academic writing that typically delves into a problem, process, or situation.

Case study methodology can entail the study of one or more "cases," that could be described as instances, examples, or settings where the problem or phenomenon can be examined. The researcher is tasked with defining the parameters of the case, that is, what is included and excluded. This process is called bounding the case , or setting boundaries.

Case study can be combined with other methodologies, such as ethnography, grounded theory, or phenomenology. In such studies the research on the case uses another framework to further define the study and refine the approach.

Case study is also described as a method, given particular approaches used to collect and analyze data. Case study research is conducted by almost every social science discipline: business, education, sociology, psychology. Case study research, with its reliance on multiple sources, is also a natural choice for researchers interested in trans-, inter-, or cross-disciplinary studies.

The Encyclopedia of case study research provides an overview:

The purpose of case study research is twofold: (1) to provide descriptive information and (2) to suggest theoretical relevance. Rich description enables an in-depth or sharpened understanding of the case.

It is unique given one characteristic: case studies draw from more than one data source. Case studies are inherently multimodal or mixed methods because this they use either more than one form of data within a research paradigm, or more than one form of data from different paradigms.

A case study inquiry could include multiple types of data:

multiple forms of quantitative data sources, such as Big Data + a survey

multiple forms of qualitative data sources, such as interviews + observations + documents

multiple forms of quantitative and qualitative data sources, such as surveys + interviews

Case study methodology can be used to achieve different research purposes.

Robert Yin , methodologist most associated with case study research, differentiates between descriptive , exploratory and explanatory case studies:

Descriptive : A case study whose purpose is to describe a phenomenon. Explanatory : A case study whose purpose is to explain how or why some condition came to be, or why some sequence of events occurred or did not occur. Exploratory: A case study whose purpose is to identify the research questions or procedures to be used in a subsequent study.

Robert Yin’s book is a comprehensive guide for case study researchers!

You can read the preface and Chapter 1 of Yin's book here . See the open-access articles below for some published examples of qualitative, quantitative, and mixed methods case study research.

Mills, A. J., Durepos, G., & Wiebe, E. (2010).  Encyclopedia of case study research (Vols. 1-0). Thousand Oaks, CA: SAGE Publications, Inc. doi: 10.4135/9781412957397

Yin, R. K. (2018). Case study research and applications (6th ed.). Thousand Oaks: SAGE Publications.

Open-Access Articles Using Case Study Methodology

As you can see from this collection, case study methods are used in qualitative, quantitative and mixed methods research.

Ang, C.-S., Lee, K.-F., & Dipolog-Ubanan, G. F. (2019). Determinants of First-Year Student Identity and Satisfaction in Higher Education: A Quantitative Case Study. SAGE Open. https://doi.org/10.1177/2158244019846689

Abstract. First-year undergraduates’ expectations and experience of university and student engagement variables were investigated to determine how these perceptions influence their student identity and overall course satisfaction. Data collected from 554 first-year undergraduates at a large private university were analyzed. Participants were given the adapted version of the Melbourne Centre for the Study of Higher Education Survey to self-report their learning experience and engagement in the university community. The results showed that, in general, the students’ reasons of pursuing tertiary education were to open the door to career opportunities and skill development. Moreover, students’ views on their learning and university engagement were at the moderate level. In relation to student identity and overall student satisfaction, it is encouraging to state that their perceptions of studentship and course satisfaction were rather positive. After controlling for demographics, student engagement appeared to explain more variance in student identity, whereas students’ expectations and experience explained greater variance in students’ overall course satisfaction. Implications for practice, limitations, and recommendation of this study are addressed.

Baker, A. J. (2017). Algorithms to Assess Music Cities: Case Study—Melbourne as a Music Capital. SAGE Open. https://doi.org/10.1177/2158244017691801

Abstract. The global  Mastering of a Music City  report in 2015 notes that the concept of music cities has penetrated the global political vernacular because it delivers “significant economic, employment, cultural and social benefits.” This article highlights that no empirical study has combined all these values and offers a relevant and comprehensive definition of a music city. Drawing on industry research,1 the article assesses how mathematical flowcharts, such as Algorithm A (Economics), Algorithm B (Four T’s creative index), and Algorithm C (Heritage), have contributed to the definition of a music city. Taking Melbourne as a case study, it illustrates how Algorithms A and B are used as disputed evidence about whether the city is touted as Australia’s music capital. The article connects the three algorithms to an academic framework from musicology, urban studies, cultural economics, and sociology, and proposes a benchmark Algorithm D (Music Cities definition), which offers a more holistic assessment of music activity in any urban context. The article concludes by arguing that Algorithm D offers a much-needed definition of what comprises a music city because it builds on the popular political economy focus and includes the social importance of space and cultural practices.

Brown, K., & Mondon, A. (2020). Populism, the media, and the mainstreaming of the far right: The Guardian’s coverage of populism as a case study. Politics. https://doi.org/10.1177/0263395720955036

Abstract. Populism seems to define our current political age. The term is splashed across the headlines, brandished in political speeches and commentaries, and applied extensively in numerous academic publications and conferences. This pervasive usage, or populist hype, has serious implications for our understanding of the meaning of populism itself and for our interpretation of the phenomena to which it is applied. In particular, we argue that its common conflation with far-right politics, as well as its breadth of application to other phenomena, has contributed to the mainstreaming of the far right in three main ways: (1) agenda-setting power and deflection, (2) euphemisation and trivialisation, and (3) amplification. Through a mixed-methods approach to discourse analysis, this article uses  The Guardian  newspaper as a case study to explore the development of the populist hype and the detrimental effects of the logics that it has pushed in public discourse.

Droy, L. T., Goodwin, J., & O’Connor, H. (2020). Methodological Uncertainty and Multi-Strategy Analysis: Case Study of the Long-Term Effects of Government Sponsored Youth Training on Occupational Mobility. Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique, 147–148(1–2), 200–230. https://doi.org/10.1177/0759106320939893

Abstract. Sociological practitioners often face considerable methodological uncertainty when undertaking a quantitative analysis. This methodological uncertainty encompasses both data construction (e.g. defining variables) and analysis (e.g. selecting and specifying a modelling procedure). Methodological uncertainty can lead to results that are fragile and arbitrary. Yet, many practitioners may be unaware of the potential scale of methodological uncertainty in quantitative analysis, and the recent emergence of techniques for addressing it. Recent proposals for ‘multi-strategy’ approaches seek to identify and manage methodological uncertainty in quantitative analysis. We present a case-study of a multi-strategy analysis, applied to the problem of estimating the long-term impact of 1980s UK government-sponsored youth training. We use this case study to further highlight the problem of cumulative methodological fragilities in applied quantitative sociology and to discuss and help develop multi-strategy analysis as a tool to address them.

Ebneyamini, S., & Sadeghi Moghadam, M. R. (2018). Toward Developing a Framework for Conducting Case Study Research .  International Journal of Qualitative Methods .  https://doi.org/10.1177/1609406918817954

Abstract. This article reviews the use of case study research for both practical and theoretical issues especially in management field with the emphasis on management of technology and innovation. Many researchers commented on the methodological issues of the case study research from their point of view thus, presenting a comprehensive framework was missing. We try representing a general framework with methodological and analytical perspective to design, develop, and conduct case study research. To test the coverage of our framework, we have analyzed articles in three major journals related to the management of technology and innovation to approve our framework. This study represents a general structure to guide, design, and fulfill a case study research with levels and steps necessary for researchers to use in their research.

Lai, D., & Roccu, R. (2019). Case study research and critical IR: the case for the extended case methodology. International Relations , 33 (1), 67-87. https://doi.org/10.1177/0047117818818243

Abstract. Discussions on case study methodology in International Relations (IR) have historically been dominated by positivist and neopositivist approaches. However, these are problematic for critical IR research, pointing to the need for a non-positivist case study methodology. To address this issue, this article introduces and adapts the extended case methodology as a critical, reflexivist approach to case study research, whereby the case is constructed through a dynamic interaction with theory, rather than selected, and knowledge is produced through extensions rather than generalisation. Insofar as it seeks to study the world in complex and non-linear terms, take context and positionality seriously, and generate explicitly political and emancipatory knowledge, the extended case methodology is consistent with the ontological and epistemological commitments of several critical IR approaches. Its potential is illustrated in the final part of the article with reference to researching the socioeconomic dimension of transitional justice in Bosnia and Herzegovina.

Lynch, R., Young, J. C., Boakye-Achampong, S., Jowaisas, C., Sam, J., & Norlander, B. (2020). Benefits of crowdsourcing for libraries: A case study from Africa . IFLA Journal. https://doi.org/10.1177/0340035220944940

Abstract. Many libraries in the Global South do not collect comprehensive data about themselves, which creates challenges in terms of local and international visibility. Crowdsourcing is an effective tool that engages the public to collect missing data, and it has proven to be particularly valuable in countries where governments collect little public data. Whereas crowdsourcing is often used within fields that have high levels of development funding, such as health, the authors believe that this approach would have many benefits for the library field as well. They present qualitative and quantitative evidence from 23 African countries involved in a crowdsourcing project to map libraries. The authors find benefits in terms of increased connections between stakeholders, capacity-building, and increased local visibility. These findings demonstrate the potential of crowdsourced approaches for tasks such as mapping to benefit libraries and similarly positioned institutions in the Global South in multifaceted ways.

Mason, W., Morris, K., Webb, C., Daniels, B., Featherstone, B., Bywaters, P., Mirza, N., Hooper, J., Brady, G., Bunting, L., & Scourfield, J. (2020). Toward Full Integration of Quantitative and Qualitative Methods in Case Study Research: Insights From Investigating Child Welfare Inequalities. Journal of Mixed Methods Research, 14 (2), 164-183. https://doi.org/10.1177/1558689819857972

Abstract. Delineation of the full integration of quantitative and qualitative methods throughout all stages of multisite mixed methods case study projects remains a gap in the methodological literature. This article offers advances to the field of mixed methods by detailing the application and integration of mixed methods throughout all stages of one such project; a study of child welfare inequalities. By offering a critical discussion of site selection and the management of confirmatory, expansionary and discordant data, this article contributes to the limited body of mixed methods exemplars specific to this field. We propose that our mixed methods approach provided distinctive insights into a complex social problem, offering expanded understandings of the relationship between poverty, child abuse, and neglect.

Rashid, Y., Rashid, A., Warraich, M. A., Sabir, S. S., & Waseem, A. (2019). Case Study Method: A Step-by-Step Guide for Business Researchers .  International Journal of Qualitative Methods .  https://doi.org/10.1177/1609406919862424

Abstract. Qualitative case study methodology enables researchers to conduct an in-depth exploration of intricate phenomena within some specific context. By keeping in mind research students, this article presents a systematic step-by-step guide to conduct a case study in the business discipline. Research students belonging to said discipline face issues in terms of clarity, selection, and operationalization of qualitative case study while doing their final dissertation. These issues often lead to confusion, wastage of valuable time, and wrong decisions that affect the overall outcome of the research. This article presents a checklist comprised of four phases, that is, foundation phase, prefield phase, field phase, and reporting phase. The objective of this article is to provide novice researchers with practical application of this checklist by linking all its four phases with the authors’ experiences and learning from recently conducted in-depth multiple case studies in the organizations of New Zealand. Rather than discussing case study in general, a targeted step-by-step plan with real-time research examples to conduct a case study is given.

VanWynsberghe, R., & Khan, S. (2007). Redefining Case Study. International Journal of Qualitative Methods, 80–94. https://doi.org/10.1177/160940690700600208

Abstract. In this paper the authors propose a more precise and encompassing definition of case study than is usually found. They support their definition by clarifying that case study is neither a method nor a methodology nor a research design as suggested by others. They use a case study prototype of their own design to propose common properties of case study and demonstrate how these properties support their definition. Next, they present several living myths about case study and refute them in relation to their definition. Finally, they discuss the interplay between the terms case study and unit of analysis to further delineate their definition of case study. The target audiences for this paper include case study researchers, research design and methods instructors, and graduate students interested in case study research.

More Sage Research Methods Community Posts about Case Study Research

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Find an 10-step process for using research cases to teach methods with learning activities for individual students, teams, or small groups. (Or use the approach yourself!)

How do you decide which methodology fits your study? In this dialogue Linda Bloomberg and Janet Boberg explain the importance of a strategic approach to qualitative research design that stresses alignment with the purpose of the study.

Case study methods are used by researchers in many disciplines. Here are some open-access articles about multimodal qualitative or mixed methods designs that include both qualitative and quantitative elements.

Case study methodology is both unique, and uniquely confusing. It is unique given one characteristic: case studies draw from more than one data source.

What is case study methodology? It is unique given one characteristic: case studies draw from more than one data source. In this post find definitions and a collection of multidisciplinary examples.

Find discussion of case studies and published examples.

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• Knowledge Base

Methodology

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

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

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

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

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

Table of contents

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

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

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

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

Prevent plagiarism. Run a free check.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Research bias

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

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McCombes, S. (2023, November 20). What Is a Case Study? | Definition, Examples & Methods. Scribbr. Retrieved July 11, 2024, from https://www.scribbr.com/methodology/case-study/

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• Knowledge Base
• Methodology
• Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

Published on 5 May 2022 by Shona McCombes . Revised on 30 January 2023.

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

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

Table of contents

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

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

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

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

Prevent plagiarism, run a free check.

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

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

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

If you find yourself aiming to simultaneously investigate and solve an issue, consider conducting action research . As its name suggests, action research conducts research and takes action at the same time, and is highly iterative and flexible. 

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

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

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

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

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

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

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

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

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

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

Cite this Scribbr article

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

McCombes, S. (2023, January 30). Case Study | Definition, Examples & Methods. Scribbr. Retrieved 10 July 2024, from https://www.scribbr.co.uk/research-methods/case-studies/

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Other students also liked, correlational research | guide, design & examples, a quick guide to experimental design | 5 steps & examples, descriptive research design | definition, methods & examples.

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

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

Research question

• Conceptual framework
• Conceptual vs. theoretical framework

Data collection

• Qualitative research methods
• Focus groups
• Observational research

What is a case study?

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

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

Case studies

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

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

Definition of a case study

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

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

Characteristics of case studies

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

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

The role of case studies in research

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

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

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

What is the purpose of a case study?

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

Why use case studies in qualitative research?

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

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

The explanatory, exploratory, and descriptive roles of case studies

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

The impact of case studies on knowledge development

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

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

Types of case studies

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

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

Exploratory case studies

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

Descriptive case studies

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

Explanatory case studies

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

Intrinsic, instrumental, and collective case studies

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

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

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

Critical information systems research

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

Health research

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

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

Asthma research studies

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

Other fields

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

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

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

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

Propositions

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

Units of analysis

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

Argumentation

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

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

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

Defining the research question

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

Selecting and defining the case

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

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

Developing a detailed case study protocol

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

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

Collecting data

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

Analyzing and interpreting data

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

Writing the case study report

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

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

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

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

Observations

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

Documents and artifacts

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

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

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

Ensuring the quality of data collection

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

Data analysis

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

Organizing the data

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

Categorizing and coding the data

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

Identifying patterns and themes

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

Interpreting the data

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

Verification of the data

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

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

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

Benefits include the following:

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

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

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

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

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Methodology or method? A critical review of qualitative case study reports

Despite on-going debate about credibility, and reported limitations in comparison to other approaches, case study is an increasingly popular approach among qualitative researchers. We critically analysed the methodological descriptions of published case studies. Three high-impact qualitative methods journals were searched to locate case studies published in the past 5 years; 34 were selected for analysis. Articles were categorized as health and health services ( n= 12), social sciences and anthropology ( n= 7), or methods ( n= 15) case studies. The articles were reviewed using an adapted version of established criteria to determine whether adequate methodological justification was present, and if study aims, methods, and reported findings were consistent with a qualitative case study approach. Findings were grouped into five themes outlining key methodological issues: case study methodology or method, case of something particular and case selection, contextually bound case study, researcher and case interactions and triangulation, and study design inconsistent with methodology reported. Improved reporting of case studies by qualitative researchers will advance the methodology for the benefit of researchers and practitioners.

Case study research is an increasingly popular approach among qualitative researchers (Thomas, 2011 ). Several prominent authors have contributed to methodological developments, which has increased the popularity of case study approaches across disciplines (Creswell, 2013b ; Denzin & Lincoln, 2011b ; Merriam, 2009 ; Ragin & Becker, 1992 ; Stake, 1995 ; Yin, 2009 ). Current qualitative case study approaches are shaped by paradigm, study design, and selection of methods, and, as a result, case studies in the published literature vary. Differences between published case studies can make it difficult for researchers to define and understand case study as a methodology.

Experienced qualitative researchers have identified case study research as a stand-alone qualitative approach (Denzin & Lincoln, 2011b ). Case study research has a level of flexibility that is not readily offered by other qualitative approaches such as grounded theory or phenomenology. Case studies are designed to suit the case and research question and published case studies demonstrate wide diversity in study design. There are two popular case study approaches in qualitative research. The first, proposed by Stake ( 1995 ) and Merriam ( 2009 ), is situated in a social constructivist paradigm, whereas the second, by Yin ( 2012 ), Flyvbjerg ( 2011 ), and Eisenhardt ( 1989 ), approaches case study from a post-positivist viewpoint. Scholarship from both schools of inquiry has contributed to the popularity of case study and development of theoretical frameworks and principles that characterize the methodology.

The diversity of case studies reported in the published literature, and on-going debates about credibility and the use of case study in qualitative research practice, suggests that differences in perspectives on case study methodology may prevent researchers from developing a mutual understanding of practice and rigour. In addition, discussion about case study limitations has led some authors to query whether case study is indeed a methodology (Luck, Jackson, & Usher, 2006 ; Meyer, 2001 ; Thomas, 2010 ; Tight, 2010 ). Methodological discussion of qualitative case study research is timely, and a review is required to analyse and understand how this methodology is applied in the qualitative research literature. The aims of this study were to review methodological descriptions of published qualitative case studies, to review how the case study methodological approach was applied, and to identify issues that need to be addressed by researchers, editors, and reviewers. An outline of the current definitions of case study and an overview of the issues proposed in the qualitative methodological literature are provided to set the scene for the review.

Definitions of qualitative case study research

Case study research is an investigation and analysis of a single or collective case, intended to capture the complexity of the object of study (Stake, 1995 ). Qualitative case study research, as described by Stake ( 1995 ), draws together “naturalistic, holistic, ethnographic, phenomenological, and biographic research methods” in a bricoleur design, or in his words, “a palette of methods” (Stake, 1995 , pp. xi–xii). Case study methodology maintains deep connections to core values and intentions and is “particularistic, descriptive and heuristic” (Merriam, 2009 , p. 46).

As a study design, case study is defined by interest in individual cases rather than the methods of inquiry used. The selection of methods is informed by researcher and case intuition and makes use of naturally occurring sources of knowledge, such as people or observations of interactions that occur in the physical space (Stake, 1998 ). Thomas ( 2011 ) suggested that “analytical eclecticism” is a defining factor (p. 512). Multiple data collection and analysis methods are adopted to further develop and understand the case, shaped by context and emergent data (Stake, 1995 ). This qualitative approach “explores a real-life, contemporary bounded system (a case ) or multiple bounded systems (cases) over time, through detailed, in-depth data collection involving multiple sources of information … and reports a case description and case themes ” (Creswell, 2013b , p. 97). Case study research has been defined by the unit of analysis, the process of study, and the outcome or end product, all essentially the case (Merriam, 2009 ).

The case is an object to be studied for an identified reason that is peculiar or particular. Classification of the case and case selection procedures informs development of the study design and clarifies the research question. Stake ( 1995 ) proposed three types of cases and study design frameworks. These include the intrinsic case, the instrumental case, and the collective instrumental case. The intrinsic case is used to understand the particulars of a single case, rather than what it represents. An instrumental case study provides insight on an issue or is used to refine theory. The case is selected to advance understanding of the object of interest. A collective refers to an instrumental case which is studied as multiple, nested cases, observed in unison, parallel, or sequential order. More than one case can be simultaneously studied; however, each case study is a concentrated, single inquiry, studied holistically in its own entirety (Stake, 1995 , 1998 ).

Researchers who use case study are urged to seek out what is common and what is particular about the case. This involves careful and in-depth consideration of the nature of the case, historical background, physical setting, and other institutional and political contextual factors (Stake, 1998 ). An interpretive or social constructivist approach to qualitative case study research supports a transactional method of inquiry, where the researcher has a personal interaction with the case. The case is developed in a relationship between the researcher and informants, and presented to engage the reader, inviting them to join in this interaction and in case discovery (Stake, 1995 ). A postpositivist approach to case study involves developing a clear case study protocol with careful consideration of validity and potential bias, which might involve an exploratory or pilot phase, and ensures that all elements of the case are measured and adequately described (Yin, 2009 , 2012 ).

Current methodological issues in qualitative case study research

The future of qualitative research will be influenced and constructed by the way research is conducted, and by what is reviewed and published in academic journals (Morse, 2011 ). If case study research is to further develop as a principal qualitative methodological approach, and make a valued contribution to the field of qualitative inquiry, issues related to methodological credibility must be considered. Researchers are required to demonstrate rigour through adequate descriptions of methodological foundations. Case studies published without sufficient detail for the reader to understand the study design, and without rationale for key methodological decisions, may lead to research being interpreted as lacking in quality or credibility (Hallberg, 2013 ; Morse, 2011 ).

There is a level of artistic license that is embraced by qualitative researchers and distinguishes practice, which nurtures creativity, innovation, and reflexivity (Denzin & Lincoln, 2011b ; Morse, 2009 ). Qualitative research is “inherently multimethod” (Denzin & Lincoln, 2011a , p. 5); however, with this creative freedom, it is important for researchers to provide adequate description for methodological justification (Meyer, 2001 ). This includes paradigm and theoretical perspectives that have influenced study design. Without adequate description, study design might not be understood by the reader, and can appear to be dishonest or inaccurate. Reviewers and readers might be confused by the inconsistent or inappropriate terms used to describe case study research approach and methods, and be distracted from important study findings (Sandelowski, 2000 ). This issue extends beyond case study research, and others have noted inconsistencies in reporting of methodology and method by qualitative researchers. Sandelowski ( 2000 , 2010 ) argued for accurate identification of qualitative description as a research approach. She recommended that the selected methodology should be harmonious with the study design, and be reflected in methods and analysis techniques. Similarly, Webb and Kevern ( 2000 ) uncovered inconsistencies in qualitative nursing research with focus group methods, recommending that methodological procedures must cite seminal authors and be applied with respect to the selected theoretical framework. Incorrect labelling using case study might stem from the flexibility in case study design and non-directional character relative to other approaches (Rosenberg & Yates, 2007 ). Methodological integrity is required in design of qualitative studies, including case study, to ensure study rigour and to enhance credibility of the field (Morse, 2011 ).

Case study has been unnecessarily devalued by comparisons with statistical methods (Eisenhardt, 1989 ; Flyvbjerg, 2006 , 2011 ; Jensen & Rodgers, 2001 ; Piekkari, Welch, & Paavilainen, 2009 ; Tight, 2010 ; Yin, 1999 ). It is reputed to be the “the weak sibling” in comparison to other, more rigorous, approaches (Yin, 2009 , p. xiii). Case study is not an inherently comparative approach to research. The objective is not statistical research, and the aim is not to produce outcomes that are generalizable to all populations (Thomas, 2011 ). Comparisons between case study and statistical research do little to advance this qualitative approach, and fail to recognize its inherent value, which can be better understood from the interpretive or social constructionist viewpoint of other authors (Merriam, 2009 ; Stake, 1995 ). Building on discussions relating to “fuzzy” (Bassey, 2001 ), or naturalistic generalizations (Stake, 1978 ), or transference of concepts and theories (Ayres, Kavanaugh, & Knafl, 2003 ; Morse et al., 2011 ) would have more relevance.

Case study research has been used as a catch-all design to justify or add weight to fundamental qualitative descriptive studies that do not fit with other traditional frameworks (Merriam, 2009 ). A case study has been a “convenient label for our research—when we ‘can't think of anything ‘better”—in an attempt to give it [qualitative methodology] some added respectability” (Tight, 2010 , p. 337). Qualitative case study research is a pliable approach (Merriam, 2009 ; Meyer, 2001 ; Stake, 1995 ), and has been likened to a “curious methodological limbo” (Gerring, 2004 , p. 341) or “paradigmatic bridge” (Luck et al., 2006 , p. 104), that is on the borderline between postpositivist and constructionist interpretations. This has resulted in inconsistency in application, which indicates that flexibility comes with limitations (Meyer, 2001 ), and the open nature of case study research might be off-putting to novice researchers (Thomas, 2011 ). The development of a well-(in)formed theoretical framework to guide a case study should improve consistency, rigour, and trust in studies published in qualitative research journals (Meyer, 2001 ).

Assessment of rigour

The purpose of this study was to analyse the methodological descriptions of case studies published in qualitative methods journals. To do this we needed to develop a suitable framework, which used existing, established criteria for appraising qualitative case study research rigour (Creswell, 2013b ; Merriam, 2009 ; Stake, 1995 ). A number of qualitative authors have developed concepts and criteria that are used to determine whether a study is rigorous (Denzin & Lincoln, 2011b ; Lincoln, 1995 ; Sandelowski & Barroso, 2002 ). The criteria proposed by Stake ( 1995 ) provide a framework for readers and reviewers to make judgements regarding case study quality, and identify key characteristics essential for good methodological rigour. Although each of the factors listed in Stake's criteria could enhance the quality of a qualitative research report, in Table I we present an adapted criteria used in this study, which integrates more recent work by Merriam ( 2009 ) and Creswell ( 2013b ). Stake's ( 1995 ) original criteria were separated into two categories. The first list of general criteria is “relevant for all qualitative research.” The second list, “high relevance to qualitative case study research,” was the criteria that we decided had higher relevance to case study research. This second list was the main criteria used to assess the methodological descriptions of the case studies reviewed. The complete table has been preserved so that the reader can determine how the original criteria were adapted.

Framework for assessing quality in qualitative case study research.

Adapted from Stake ( 1995 , p. 131).

Study design

The critical review method described by Grant and Booth ( 2009 ) was used, which is appropriate for the assessment of research quality, and is used for literature analysis to inform research and practice. This type of review goes beyond the mapping and description of scoping or rapid reviews, to include “analysis and conceptual innovation” (Grant & Booth, 2009 , p. 93). A critical review is used to develop existing, or produce new, hypotheses or models. This is different to systematic reviews that answer clinical questions. It is used to evaluate existing research and competing ideas, to provide a “launch pad” for conceptual development and “subsequent testing” (Grant & Booth, 2009 , p. 93).

Qualitative methods journals were located by a search of the 2011 ISI Journal Citation Reports in Social Science, via the database Web of Knowledge (see m.webofknowledge.com). No “qualitative research methods” category existed in the citation reports; therefore, a search of all categories was performed using the term “qualitative.” In Table II , we present the qualitative methods journals located, ranked by impact factor. The highest ranked journals were selected for searching. We acknowledge that the impact factor ranking system might not be the best measure of journal quality (Cheek, Garnham, & Quan, 2006 ); however, this was the most appropriate and accessible method available.

International Journal of Qualitative Studies on Health and Well-being.

Search strategy

In March 2013, searches of the journals, Qualitative Health Research , Qualitative Research , and Qualitative Inquiry were completed to retrieve studies with “case study” in the abstract field. The search was limited to the past 5 years (1 January 2008 to 1 March 2013). The objective was to locate published qualitative case studies suitable for assessment using the adapted criterion. Viewpoints, commentaries, and other article types were excluded from review. Title and abstracts of the 45 retrieved articles were read by the first author, who identified 34 empirical case studies for review. All authors reviewed the 34 studies to confirm selection and categorization. In Table III , we present the 34 case studies grouped by journal, and categorized by research topic, including health sciences, social sciences and anthropology, and methods research. There was a discrepancy in categorization of one article on pedagogy and a new teaching method published in Qualitative Inquiry (Jorrín-Abellán, Rubia-Avi, Anguita-Martínez, Gómez-Sánchez, & Martínez-Mones, 2008 ). Consensus was to allocate to the methods category.

Outcomes of search of qualitative methods journals.

In Table III , the number of studies located, and final numbers selected for review have been reported. Qualitative Health Research published the most empirical case studies ( n= 16). In the health category, there were 12 case studies of health conditions, health services, and health policy issues, all published in Qualitative Health Research . Seven case studies were categorized as social sciences and anthropology research, which combined case study with biography and ethnography methodologies. All three journals published case studies on methods research to illustrate a data collection or analysis technique, methodological procedure, or related issue.

The methodological descriptions of 34 case studies were critically reviewed using the adapted criteria. All articles reviewed contained a description of study methods; however, the length, amount of detail, and position of the description in the article varied. Few studies provided an accurate description and rationale for using a qualitative case study approach. In the 34 case studies reviewed, three described a theoretical framework informed by Stake ( 1995 ), two by Yin ( 2009 ), and three provided a mixed framework informed by various authors, which might have included both Yin and Stake. Few studies described their case study design, or included a rationale that explained why they excluded or added further procedures, and whether this was to enhance the study design, or to better suit the research question. In 26 of the studies no reference was provided to principal case study authors. From reviewing the description of methods, few authors provided a description or justification of case study methodology that demonstrated how their study was informed by the methodological literature that exists on this approach.

The methodological descriptions of each study were reviewed using the adapted criteria, and the following issues were identified: case study methodology or method; case of something particular and case selection; contextually bound case study; researcher and case interactions and triangulation; and, study design inconsistent with methodology. An outline of how the issues were developed from the critical review is provided, followed by a discussion of how these relate to the current methodological literature.

Case study methodology or method

A third of the case studies reviewed appeared to use a case report method, not case study methodology as described by principal authors (Creswell, 2013b ; Merriam, 2009 ; Stake, 1995 ; Yin, 2009 ). Case studies were identified as a case report because of missing methodological detail and by review of the study aims and purpose. These reports presented data for small samples of no more than three people, places or phenomenon. Four studies, or “case reports” were single cases selected retrospectively from larger studies (Bronken, Kirkevold, Martinsen, & Kvigne, 2012 ; Coltart & Henwood, 2012 ; Hooghe, Neimeyer, & Rober, 2012 ; Roscigno et al., 2012 ). Case reports were not a case of something, instead were a case demonstration or an example presented in a report. These reports presented outcomes, and reported on how the case could be generalized. Descriptions focussed on the phenomena, rather than the case itself, and did not appear to study the case in its entirety.

Case reports had minimal in-text references to case study methodology, and were informed by other qualitative traditions or secondary sources (Adamson & Holloway, 2012 ; Buzzanell & D'Enbeau, 2009 ; Nagar-Ron & Motzafi-Haller, 2011 ). This does not suggest that case study methodology cannot be multimethod, however, methodology should be consistent in design, be clearly described (Meyer, 2001 ; Stake, 1995 ), and maintain focus on the case (Creswell, 2013b ).

To demonstrate how case reports were identified, three examples are provided. The first, Yeh ( 2013 ) described their study as, “the examination of the emergence of vegetarianism in Victorian England serves as a case study to reveal the relationships between boundaries and entities” (p. 306). The findings were a historical case report, which resulted from an ethnographic study of vegetarianism. Cunsolo Willox, Harper, Edge, ‘My Word’: Storytelling and Digital Media Lab, and Rigolet Inuit Community Government (2013) used “a case study that illustrates the usage of digital storytelling within an Inuit community” (p. 130). This case study reported how digital storytelling can be used with indigenous communities as a participatory method to illuminate the benefits of this method for other studies. This “case study was conducted in the Inuit community” but did not include the Inuit community in case analysis (Cunsolo Willox et al., 2013 , p. 130). Bronken et al. ( 2012 ) provided a single case report to demonstrate issues observed in a larger clinical study of aphasia and stroke, without adequate case description or analysis.

Case study of something particular and case selection

Case selection is a precursor to case analysis, which needs to be presented as a convincing argument (Merriam, 2009 ). Descriptions of the case were often not adequate to ascertain why the case was selected, or whether it was a particular exemplar or outlier (Thomas, 2011 ). In a number of case studies in the health and social science categories, it was not explicit whether the case was of something particular, or peculiar to their discipline or field (Adamson & Holloway, 2012 ; Bronken et al., 2012 ; Colón-Emeric et al., 2010 ; Jackson, Botelho, Welch, Joseph, & Tennstedt, 2012 ; Mawn et al., 2010 ; Snyder-Young, 2011 ). There were exceptions in the methods category ( Table III ), where cases were selected by researchers to report on a new or innovative method. The cases emerged through heuristic study, and were reported to be particular, relative to the existing methods literature (Ajodhia-Andrews & Berman, 2009 ; Buckley & Waring, 2013 ; Cunsolo Willox et al., 2013 ; De Haene, Grietens, & Verschueren, 2010 ; Gratton & O'Donnell, 2011 ; Sumsion, 2013 ; Wimpenny & Savin-Baden, 2012 ).

Case selection processes were sometimes insufficient to understand why the case was selected from the global population of cases, or what study of this case would contribute to knowledge as compared with other possible cases (Adamson & Holloway, 2012 ; Bronken et al., 2012 ; Colón-Emeric et al., 2010 ; Jackson et al., 2012 ; Mawn et al., 2010 ). In two studies, local cases were selected (Barone, 2010 ; Fourie & Theron, 2012 ) because the researcher was familiar with and had access to the case. Possible limitations of a convenience sample were not acknowledged. Purposeful sampling was used to recruit participants within the case of one study, but not of the case itself (Gallagher et al., 2013 ). Random sampling was completed for case selection in two studies (Colón-Emeric et al., 2010 ; Jackson et al., 2012 ), which has limited meaning in interpretive qualitative research.

To demonstrate how researchers provided a good justification for the selection of case study approaches, four examples are provided. The first, cases of residential care homes, were selected because of reported occurrences of mistreatment, which included residents being locked in rooms at night (Rytterström, Unosson, & Arman, 2013 ). Roscigno et al. ( 2012 ) selected cases of parents who were admitted for early hospitalization in neonatal intensive care with a threatened preterm delivery before 26 weeks. Hooghe et al. ( 2012 ) used random sampling to select 20 couples that had experienced the death of a child; however, the case study was of one couple and a particular metaphor described only by them. The final example, Coltart and Henwood ( 2012 ), provided a detailed account of how they selected two cases from a sample of 46 fathers based on personal characteristics and beliefs. They described how the analysis of the two cases would contribute to their larger study on first time fathers and parenting.

Contextually bound case study

The limits or boundaries of the case are a defining factor of case study methodology (Merriam, 2009 ; Ragin & Becker, 1992 ; Stake, 1995 ; Yin, 2009 ). Adequate contextual description is required to understand the setting or context in which the case is revealed. In the health category, case studies were used to illustrate a clinical phenomenon or issue such as compliance and health behaviour (Colón-Emeric et al., 2010 ; D'Enbeau, Buzzanell, & Duckworth, 2010 ; Gallagher et al., 2013 ; Hooghe et al., 2012 ; Jackson et al., 2012 ; Roscigno et al., 2012 ). In these case studies, contextual boundaries, such as physical and institutional descriptions, were not sufficient to understand the case as a holistic system, for example, the general practitioner (GP) clinic in Gallagher et al. ( 2013 ), or the nursing home in Colón-Emeric et al. ( 2010 ). Similarly, in the social science and methods categories, attention was paid to some components of the case context, but not others, missing important information required to understand the case as a holistic system (Alexander, Moreira, & Kumar, 2012 ; Buzzanell & D'Enbeau, 2009 ; Nairn & Panelli, 2009 ; Wimpenny & Savin-Baden, 2012 ).

In two studies, vicarious experience or vignettes (Nairn & Panelli, 2009 ) and images (Jorrín-Abellán et al., 2008 ) were effective to support description of context, and might have been a useful addition for other case studies. Missing contextual boundaries suggests that the case might not be adequately defined. Additional information, such as the physical, institutional, political, and community context, would improve understanding of the case (Stake, 1998 ). In Boxes 1 and 2 , we present brief synopses of two studies that were reviewed, which demonstrated a well bounded case. In Box 1 , Ledderer ( 2011 ) used a qualitative case study design informed by Stake's tradition. In Box 2 , Gillard, Witt, and Watts ( 2011 ) were informed by Yin's tradition. By providing a brief outline of the case studies in Boxes 1 and 2 , we demonstrate how effective case boundaries can be constructed and reported, which may be of particular interest to prospective case study researchers.

Article synopsis of case study research using Stake's tradition

Ledderer ( 2011 ) used a qualitative case study research design, informed by modern ethnography. The study is bounded to 10 general practice clinics in Denmark, who had received federal funding to implement preventative care services based on a Motivational Interviewing intervention. The researcher question focussed on “why is it so difficult to create change in medical practice?” (Ledderer, 2011 , p. 27). The study context was adequately described, providing detail on the general practitioner (GP) clinics and relevant political and economic influences. Methodological decisions are described in first person narrative, providing insight on researcher perspectives and interaction with the case. Forty-four interviews were conducted, which focussed on how GPs conducted consultations, and the form, nature and content, rather than asking their opinion or experience (Ledderer, 2011 , p. 30). The duration and intensity of researcher immersion in the case enhanced depth of description and trustworthiness of study findings. Analysis was consistent with Stake's tradition, and the researcher provided examples of inquiry techniques used to challenge assumptions about emerging themes. Several other seminal qualitative works were cited. The themes and typology constructed are rich in narrative data and storytelling by clinic staff, demonstrating individual clinic experiences as well as shared meanings and understandings about changing from a biomedical to psychological approach to preventative health intervention. Conclusions make note of social and cultural meanings and lessons learned, which might not have been uncovered using a different methodology.

Article synopsis of case study research using Yin's tradition

Gillard et al. ( 2011 ) study of camps for adolescents living with HIV/AIDs provided a good example of Yin's interpretive case study approach. The context of the case is bounded by the three summer camps of which the researchers had prior professional involvement. A case study protocol was developed that used multiple methods to gather information at three data collection points coinciding with three youth camps (Teen Forum, Discover Camp, and Camp Strong). Gillard and colleagues followed Yin's ( 2009 ) principles, using a consistent data protocol that enhanced cross-case analysis. Data described the young people, the camp physical environment, camp schedule, objectives and outcomes, and the staff of three youth camps. The findings provided a detailed description of the context, with less detail of individual participants, including insight into researcher's interpretations and methodological decisions throughout the data collection and analysis process. Findings provided the reader with a sense of “being there,” and are discovered through constant comparison of the case with the research issues; the case is the unit of analysis. There is evidence of researcher immersion in the case, and Gillard reports spending significant time in the field in a naturalistic and integrated youth mentor role.

This case study is not intended to have a significant impact on broader health policy, although does have implications for health professionals working with adolescents. Study conclusions will inform future camps for young people with chronic disease, and practitioners are able to compare similarities between this case and their own practice (for knowledge translation). No limitations of this article were reported. Limitations related to publication of this case study were that it was 20 pages long and used three tables to provide sufficient description of the camp and program components, and relationships with the research issue.

Researcher and case interactions and triangulation

Researcher and case interactions and transactions are a defining feature of case study methodology (Stake, 1995 ). Narrative stories, vignettes, and thick description are used to provoke vicarious experience and a sense of being there with the researcher in their interaction with the case. Few of the case studies reviewed provided details of the researcher's relationship with the case, researcher–case interactions, and how these influenced the development of the case study (Buzzanell & D'Enbeau, 2009 ; D'Enbeau et al., 2010 ; Gallagher et al., 2013 ; Gillard et al., 2011 ; Ledderer, 2011 ; Nagar-Ron & Motzafi-Haller, 2011 ). The role and position of the researcher needed to be self-examined and understood by readers, to understand how this influenced interactions with participants, and to determine what triangulation is needed (Merriam, 2009 ; Stake, 1995 ).

Gillard et al. ( 2011 ) provided a good example of triangulation, comparing data sources in a table (p. 1513). Triangulation of sources was used to reveal as much depth as possible in the study by Nagar-Ron and Motzafi-Haller ( 2011 ), while also enhancing confirmation validity. There were several case studies that would have benefited from improved range and use of data sources, and descriptions of researcher–case interactions (Ajodhia-Andrews & Berman, 2009 ; Bronken et al., 2012 ; Fincham, Scourfield, & Langer, 2008 ; Fourie & Theron, 2012 ; Hooghe et al., 2012 ; Snyder-Young, 2011 ; Yeh, 2013 ).

Study design inconsistent with methodology

Good, rigorous case studies require a strong methodological justification (Meyer, 2001 ) and a logical and coherent argument that defines paradigm, methodological position, and selection of study methods (Denzin & Lincoln, 2011b ). Methodological justification was insufficient in several of the studies reviewed (Barone, 2010 ; Bronken et al., 2012 ; Hooghe et al., 2012 ; Mawn et al., 2010 ; Roscigno et al., 2012 ; Yeh, 2013 ). This was judged by the absence, or inadequate or inconsistent reference to case study methodology in-text.

In six studies, the methodological justification provided did not relate to case study. There were common issues identified. Secondary sources were used as primary methodological references indicating that study design might not have been theoretically sound (Colón-Emeric et al., 2010 ; Coltart & Henwood, 2012 ; Roscigno et al., 2012 ; Snyder-Young, 2011 ). Authors and sources cited in methodological descriptions were inconsistent with the actual study design and practices used (Fourie & Theron, 2012 ; Hooghe et al., 2012 ; Jorrín-Abellán et al., 2008 ; Mawn et al., 2010 ; Rytterström et al., 2013 ; Wimpenny & Savin-Baden, 2012 ). This occurred when researchers cited Stake or Yin, or both (Mawn et al., 2010 ; Rytterström et al., 2013 ), although did not follow their paradigmatic or methodological approach. In 26 studies there were no citations for a case study methodological approach.

The findings of this study have highlighted a number of issues for researchers. A considerable number of case studies reviewed were missing key elements that define qualitative case study methodology and the tradition cited. A significant number of studies did not provide a clear methodological description or justification relevant to case study. Case studies in health and social sciences did not provide sufficient information for the reader to understand case selection, and why this case was chosen above others. The context of the cases were not described in adequate detail to understand all relevant elements of the case context, which indicated that cases may have not been contextually bounded. There were inconsistencies between reported methodology, study design, and paradigmatic approach in case studies reviewed, which made it difficult to understand the study methodology and theoretical foundations. These issues have implications for methodological integrity and honesty when reporting study design, which are values of the qualitative research tradition and are ethical requirements (Wager & Kleinert, 2010a ). Poorly described methodological descriptions may lead the reader to misinterpret or discredit study findings, which limits the impact of the study, and, as a collective, hinders advancements in the broader qualitative research field.

The issues highlighted in our review build on current debates in the case study literature, and queries about the value of this methodology. Case study research can be situated within different paradigms or designed with an array of methods. In order to maintain the creativity and flexibility that is valued in this methodology, clearer descriptions of paradigm and theoretical position and methods should be provided so that study findings are not undervalued or discredited. Case study research is an interdisciplinary practice, which means that clear methodological descriptions might be more important for this approach than other methodologies that are predominantly driven by fewer disciplines (Creswell, 2013b ).

Authors frequently omit elements of methodologies and include others to strengthen study design, and we do not propose a rigid or purist ideology in this paper. On the contrary, we encourage new ideas about using case study, together with adequate reporting, which will advance the value and practice of case study. The implications of unclear methodological descriptions in the studies reviewed were that study design appeared to be inconsistent with reported methodology, and key elements required for making judgements of rigour were missing. It was not clear whether the deviations from methodological tradition were made by researchers to strengthen the study design, or because of misinterpretations. Morse ( 2011 ) recommended that innovations and deviations from practice are best made by experienced researchers, and that a novice might be unaware of the issues involved with making these changes. To perpetuate the tradition of case study research, applications in the published literature should have consistencies with traditional methodological constructions, and deviations should be described with a rationale that is inherent in study conduct and findings. Providing methodological descriptions that demonstrate a strong theoretical foundation and coherent study design will add credibility to the study, while ensuring the intrinsic meaning of case study is maintained.

The value of this review is that it contributes to discussion of whether case study is a methodology or method. We propose possible reasons why researchers might make this misinterpretation. Researchers may interchange the terms methods and methodology, and conduct research without adequate attention to epistemology and historical tradition (Carter & Little, 2007 ; Sandelowski, 2010 ). If the rich meaning that naming a qualitative methodology brings to the study is not recognized, a case study might appear to be inconsistent with the traditional approaches described by principal authors (Creswell, 2013a ; Merriam, 2009 ; Stake, 1995 ; Yin, 2009 ). If case studies are not methodologically and theoretically situated, then they might appear to be a case report.

Case reports are promoted by university and medical journals as a method of reporting on medical or scientific cases; guidelines for case reports are publicly available on websites ( http://www.hopkinsmedicine.org/institutional_review_board/guidelines_policies/guidelines/case_report.html ). The various case report guidelines provide a general criteria for case reports, which describes that this form of report does not meet the criteria of research, is used for retrospective analysis of up to three clinical cases, and is primarily illustrative and for educational purposes. Case reports can be published in academic journals, but do not require approval from a human research ethics committee. Traditionally, case reports describe a single case, to explain how and what occurred in a selected setting, for example, to illustrate a new phenomenon that has emerged from a larger study. A case report is not necessarily particular or the study of a case in its entirety, and the larger study would usually be guided by a different research methodology.

This description of a case report is similar to what was provided in some studies reviewed. This form of report lacks methodological grounding and qualities of research rigour. The case report has publication value in demonstrating an example and for dissemination of knowledge (Flanagan, 1999 ). However, case reports have different meaning and purpose to case study, which needs to be distinguished. Findings of our review suggest that the medical understanding of a case report has been confused with qualitative case study approaches.

In this review, a number of case studies did not have methodological descriptions that included key characteristics of case study listed in the adapted criteria, and several issues have been discussed. There have been calls for improvements in publication quality of qualitative research (Morse, 2011 ), and for improvements in peer review of submitted manuscripts (Carter & Little, 2007 ; Jasper, Vaismoradi, Bondas, & Turunen, 2013 ). The challenging nature of editor and reviewers responsibilities are acknowledged in the literature (Hames, 2013 ; Wager & Kleinert, 2010b ); however, review of case study methodology should be prioritized because of disputes on methodological value.

Authors using case study approaches are recommended to describe their theoretical framework and methods clearly, and to seek and follow specialist methodological advice when needed (Wager & Kleinert, 2010a ). Adequate page space for case study description would contribute to better publications (Gillard et al., 2011 ). Capitalizing on the ability to publish complementary resources should be considered.

Limitations of the review

There is a level of subjectivity involved in this type of review and this should be considered when interpreting study findings. Qualitative methods journals were selected because the aims and scope of these journals are to publish studies that contribute to methodological discussion and development of qualitative research. Generalist health and social science journals were excluded that might have contained good quality case studies. Journals in business or education were also excluded, although a review of case studies in international business journals has been published elsewhere (Piekkari et al., 2009 ).

The criteria used to assess the quality of the case studies were a set of qualitative indicators. A numerical or ranking system might have resulted in different results. Stake's ( 1995 ) criteria have been referenced elsewhere, and was deemed the best available (Creswell, 2013b ; Crowe et al., 2011 ). Not all qualitative studies are reported in a consistent way and some authors choose to report findings in a narrative form in comparison to a typical biomedical report style (Sandelowski & Barroso, 2002 ), if misinterpretations were made this may have affected the review.

Case study research is an increasingly popular approach among qualitative researchers, which provides methodological flexibility through the incorporation of different paradigmatic positions, study designs, and methods. However, whereas flexibility can be an advantage, a myriad of different interpretations has resulted in critics questioning the use of case study as a methodology. Using an adaptation of established criteria, we aimed to identify and assess the methodological descriptions of case studies in high impact, qualitative methods journals. Few articles were identified that applied qualitative case study approaches as described by experts in case study design. There were inconsistencies in methodology and study design, which indicated that researchers were confused whether case study was a methodology or a method. Commonly, there appeared to be confusion between case studies and case reports. Without clear understanding and application of the principles and key elements of case study methodology, there is a risk that the flexibility of the approach will result in haphazard reporting, and will limit its global application as a valuable, theoretically supported methodology that can be rigorously applied across disciplines and fields.

Conflict of interest and funding

The authors have not received any funding or benefits from industry or elsewhere to conduct this study.

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Case study research: opening up research opportunities

RAUSP Management Journal

ISSN : 2531-0488

Article publication date: 30 December 2019

Issue publication date: 3 March 2020

The case study approach has been widely used in management studies and the social sciences more generally. However, there are still doubts about when and how case studies should be used. This paper aims to discuss this approach, its various uses and applications, in light of epistemological principles, as well as the criteria for rigor and validity.

Design/methodology/approach

This paper discusses the various concepts of case and case studies in the methods literature and addresses the different uses of cases in relation to epistemological principles and criteria for rigor and validity.

The use of this research approach can be based on several epistemologies, provided the researcher attends to the internal coherence between method and epistemology, or what the authors call “alignment.”

Originality/value

This study offers a number of implications for the practice of management research, as it shows how the case study approach does not commit the researcher to particular data collection or interpretation methods. Furthermore, the use of cases can be justified according to multiple epistemological orientations.

• Epistemology

Takahashi, A.R.W. and Araujo, L. (2020), "Case study research: opening up research opportunities", RAUSP Management Journal , Vol. 55 No. 1, pp. 100-111. https://doi.org/10.1108/RAUSP-05-2019-0109

Emerald Publishing Limited

Copyright © 2019, Adriana Roseli Wünsch Takahashi and Luis Araujo.

Published in RAUSP Management Journal . Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

1. Introduction

The case study as a research method or strategy brings us to question the very term “case”: after all, what is a case? A case-based approach places accords the case a central role in the research process ( Ragin, 1992 ). However, doubts still remain about the status of cases according to different epistemologies and types of research designs.

Despite these doubts, the case study is ever present in the management literature and represents the main method of management research in Brazil ( Coraiola, Sander, Maccali, & Bulgacov, 2013 ). Between 2001 and 2010, 2,407 articles (83.14 per cent of qualitative research) were published in conferences and management journals as case studies (Takahashi & Semprebom, 2013 ). A search on Spell.org.br for the term “case study” under title, abstract or keywords, for the period ranging from January 2010 to July 2019, yielded 3,040 articles published in the management field. Doing research using case studies, allows the researcher to immerse him/herself in the context and gain intensive knowledge of a phenomenon, which in turn demands suitable methodological principles ( Freitas et al. , 2017 ).

Our objective in this paper is to discuss notions of what constitutes a case and its various applications, considering epistemological positions as well as criteria for rigor and validity. The alignment between these dimensions is put forward as a principle advocating coherence among all phases of the research process.

This article makes two contributions. First, we suggest that there are several epistemological justifications for using case studies. Second, we show that the quality and rigor of academic research with case studies are directly related to the alignment between epistemology and research design rather than to choices of specific forms of data collection or analysis. The article is structured as follows: the following four sections discuss concepts of what is a case, its uses, epistemological grounding as well as rigor and quality criteria. The brief conclusions summarize the debate and invite the reader to delve into the literature on the case study method as a way of furthering our understanding of contemporary management phenomena.

2. What is a case study?

The debate over what constitutes a case in social science is a long-standing one. In 1988, Howard Becker and Charles Ragin organized a workshop to discuss the status of the case as a social science method. As the discussion was inconclusive, they posed the question “What is a case?” to a select group of eight social scientists in 1989, and later to participants in a symposium on the subject. Participants were unable to come up with a consensual answer. Since then, we have witnessed that further debates and different answers have emerged. The original question led to an even broader issue: “How do we, as social scientists, produce results and seem to know what we know?” ( Ragin, 1992 , p. 16).

An important step that may help us start a reflection on what is a case is to consider the phenomena we are looking at. To do that, we must know something about what we want to understand and how we might study it. The answer may be a causal explanation, a description of what was observed or a narrative of what has been experienced. In any case, there will always be a story to be told, as the choice of the case study method demands an answer to what the case is about.

A case may be defined ex ante , prior to the start of the research process, as in Yin’s (2015) classical definition. But, there is no compelling reason as to why cases must be defined ex ante . Ragin (1992 , p. 217) proposed the notion of “casing,” to indicate that what the case is emerges from the research process:

Rather than attempt to delineate the many different meanings of the term “case” in a formal taxonomy, in this essay I offer instead a view of cases that follows from the idea implicit in many of the contributions – that concocting cases is a varied but routine social scientific activity. […] The approach of this essay is that this activity, which I call “casing”, should be viewed in practical terms as a research tactic. It is selectively invoked at many different junctures in the research process, usually to resolve difficult issues in linking ideas and evidence.

In other words, “casing” is tied to the researcher’s practice, to the way he/she delimits or declares a case as a significant outcome of a process. In 2013, Ragin revisited the 1992 concept of “casing” and explored its multiple possibilities of use, paying particular attention to “negative cases.”

According to Ragin (1992) , a case can be centered on a phenomenon or a population. In the first scenario, cases are representative of a phenomenon, and are selected based on what can be empirically observed. The process highlights different aspects of cases and obscures others according to the research design, and allows for the complexity, specificity and context of the phenomenon to be explored. In the alternative, population-focused scenario, the selection of cases precedes the research. Both positive and negative cases are considered in exploring a phenomenon, with the definition of the set of cases dependent on theory and the central objective to build generalizations. As a passing note, it is worth mentioning here that a study of multiple cases requires a definition of the unit of analysis a priori . Otherwise, it will not be possible to make cross-case comparisons.

These two approaches entail differences that go beyond the mere opposition of quantitative and qualitative data, as a case often includes both types of data. Thus, the confusion about how to conceive cases is associated with Ragin’s (1992) notion of “small vs large N,” or McKeown’s (1999) “statistical worldview” – the notion that relevant findings are only those that can be made about a population based on the analysis of representative samples. In the same vein, Byrne (2013) argues that we cannot generate nomothetic laws that apply in all circumstances, periods and locations, and that no social science method can claim to generate invariant laws. According to the same author, case studies can help us understand that there is more than one ideographic variety and help make social science useful. Generalizations still matter, but they should be understood as part of defining the research scope, and that scope points to the limitations of knowledge produced and consumed in concrete time and space.

Thus, what defines the orientation and the use of cases is not the mere choice of type of data, whether quantitative or qualitative, but the orientation of the study. A statistical worldview sees cases as data units ( Byrne, 2013 ). Put differently, there is a clear distinction between statistical and qualitative worldviews; the use of quantitative data does not by itself means that the research is (quasi) statistical, or uses a deductive logic:

Case-based methods are useful, and represent, among other things, a way of moving beyond a useless and destructive tradition in the social sciences that have set quantitative and qualitative modes of exploration, interpretation, and explanation against each other ( Byrne, 2013 , p. 9).

Other authors advocate different understandings of what a case study is. To some, it is a research method, to others it is a research strategy ( Creswell, 1998 ). Sharan Merrian and Robert Yin, among others, began to write about case study research as a methodology in the 1980s (Merrian, 2009), while authors such as Eisenhardt (1989) called it a research strategy. Stake (2003) sees the case study not as a method, but as a choice of what to be studied, the unit of study. Regardless of their differences, these authors agree that case studies should be restricted to a particular context as they aim to provide an in-depth knowledge of a given phenomenon: “A case study is an in-depth description and analysis of a bounded system” (Merrian, 2009, p. 40). According to Merrian, a qualitative case study can be defined by the process through which the research is carried out, by the unit of analysis or the final product, as the choice ultimately depends on what the researcher wants to know. As a product of research, it involves the analysis of a given entity, phenomenon or social unit.

Thus, whether it is an organization, an individual, a context or a phenomenon, single or multiple, one must delimit it, and also choose between possible types and configurations (Merrian, 2009; Yin, 2015 ). A case study may be descriptive, exploratory, explanatory, single or multiple ( Yin, 2015 ); intrinsic, instrumental or collective ( Stake, 2003 ); and confirm or build theory ( Eisenhardt, 1989 ).

both went through the same process of implementing computer labs intended for the use of information and communication technologies in 2007;

both took part in the same regional program (Paraná Digital); and

they shared similar characteristics regarding location (operation in the same neighborhood of a city), number of students, number of teachers and technicians and laboratory sizes.

However, the two institutions differed in the number of hours of program use, with one of them displaying a significant number of hours/use while the other showed a modest number, according to secondary data for the period 2007-2013. Despite the context being similar and the procedures for implementing the technology being the same, the mechanisms of social integration – an idiosyncratic factor of each institution – were different in each case. This explained differences in their use of resource, processes of organizational learning and capacity to absorb new knowledge.

On the other hand, multiple case studies seek evidence in different contexts and do not necessarily require direct comparisons ( Stake, 2003 ). Rather, there is a search for patterns of convergence and divergence that permeate all the cases, as the same issues are explored in every case. Cases can be added progressively until theoretical saturation is achieved. An example is of a study that investigated how entrepreneurial opportunity and management skills were developed through entrepreneurial learning ( Zampier & Takahashi, 2014 ). The authors conducted nine case studies, based on primary and secondary data, with each one analyzed separately, so a search for patterns could be undertaken. The convergence aspects found were: the predominant way of transforming experience into knowledge was exploitation; managerial skills were developed through by taking advantages of opportunities; and career orientation encompassed more than one style. As for divergence patterns: the experience of success and failure influenced entrepreneurs differently; the prevailing rationality logic of influence was different; and the combination of styles in career orientation was diverse.

A full discussion of choice of case study design is outside the scope of this article. For the sake of illustration, we make a brief mention to other selection criteria such as the purpose of the research, the state of the art of the research theme, the time and resources involved and the preferred epistemological position of the researcher. In the next section, we look at the possibilities of carrying out case studies in line with various epistemological traditions, as the answers to the “what is a case?” question reveal varied methodological commitments as well as diverse epistemological and ontological positions ( Ragin, 2013 ).

3. Epistemological positioning of case study research

Ontology and epistemology are like skin, not a garment to be occasionally worn ( Marsh & Furlong, 2002 ). According to these authors, ontology and epistemology guide the choice of theory and method because they cannot or should not be worn as a garment. Hence, one must practice philosophical “self-knowledge” to recognize one’s vision of what the world is and of how knowledge of that world is accessed and validated. Ontological and epistemological positions are relevant in that they involve the positioning of the researcher in social science and the phenomena he or she chooses to study. These positions do not tend to vary from one project to another although they can certainly change over time for a single researcher.

Ontology is the starting point from which the epistemological and methodological positions of the research arise ( Grix, 2002 ). Ontology expresses a view of the world, what constitutes reality, nature and the image one has of social reality; it is a theory of being ( Marsh & Furlong, 2002 ). The central question is the nature of the world out there regardless of our ability to access it. An essentialist or foundationalist ontology acknowledges that there are differences that persist over time and these differences are what underpin the construction of social life. An opposing, anti-foundationalist position presumes that the differences found are socially constructed and may vary – i.e. they are not essential but specific to a given culture at a given time ( Marsh & Furlong, 2002 ).

Epistemology is centered around a theory of knowledge, focusing on the process of acquiring and validating knowledge ( Grix, 2002 ). Positivists look at social phenomena as a world of causal relations where there is a single truth to be accessed and confirmed. In this tradition, case studies test hypotheses and rely on deductive approaches and quantitative data collection and analysis techniques. Scholars in the field of anthropology and observation-based qualitative studies proposed alternative epistemologies based on notions of the social world as a set of manifold and ever-changing processes. In management studies since the 1970s, the gradual acceptance of qualitative research has generated a diverse range of research methods and conceptions of the individual and society ( Godoy, 1995 ).

The interpretative tradition, in direct opposition to positivism, argues that there is no single objective truth to be discovered about the social world. The social world and our knowledge of it are the product of social constructions. Thus, the social world is constituted by interactions, and our knowledge is hermeneutic as the world does not exist independent of our knowledge ( Marsh & Furlong, 2002 ). The implication is that it is not possible to access social phenomena through objective, detached methods. Instead, the interaction mechanisms and relationships that make up social constructions have to be studied. Deductive approaches, hypothesis testing and quantitative methods are not relevant here. Hermeneutics, on the other hand, is highly relevant as it allows the analysis of the individual’s interpretation, of sayings, texts and actions, even though interpretation is always the “truth” of a subject. Methods such as ethnographic case studies, interviews and observations as data collection techniques should feed research designs according to interpretivism. It is worth pointing out that we are to a large extent, caricaturing polar opposites rather characterizing a range of epistemological alternatives, such as realism, conventionalism and symbolic interactionism.

If diverse ontologies and epistemologies serve as a guide to research approaches, including data collection and analysis methods, and if they should be regarded as skin rather than clothing, how does one make choices regarding case studies? What are case studies, what type of knowledge they provide and so on? The views of case study authors are not always explicit on this point, so we must delve into their texts to glean what their positions might be.

Two of the cited authors in case study research are Robert Yin and Kathleen Eisenhardt. Eisenhardt (1989) argues that a case study can serve to provide a description, test or generate a theory, the latter being the most relevant in contributing to the advancement of knowledge in a given area. She uses terms such as populations and samples, control variables, hypotheses and generalization of findings and even suggests an ideal number of case studies to allow for theory construction through replication. Although Eisenhardt includes observation and interview among her recommended data collection techniques, the approach is firmly anchored in a positivist epistemology:

Third, particularly in comparison with Strauss (1987) and Van Maanen (1988), the process described here adopts a positivist view of research. That is, the process is directed toward the development of testable hypotheses and theory which are generalizable across settings. In contrast, authors like Strauss and Van Maanen are more concerned that a rich, complex description of the specific cases under study evolve and they appear less concerned with development of generalizable theory ( Eisenhardt, 1989 , p. 546).

This position attracted a fair amount of criticism. Dyer & Wilkins (1991) in a critique of Eisenhardt’s (1989) article focused on the following aspects: there is no relevant justification for the number of cases recommended; it is the depth and not the number of cases that provides an actual contribution to theory; and the researcher’s purpose should be to get closer to the setting and interpret it. According to the same authors, discrepancies from prior expectations are also important as they lead researchers to reflect on existing theories. Eisenhardt & Graebner (2007 , p. 25) revisit the argument for the construction of a theory from multiple cases:

A major reason for the popularity and relevance of theory building from case studies is that it is one of the best (if not the best) of the bridges from rich qualitative evidence to mainstream deductive research.

Although they recognize the importance of single-case research to explore phenomena under unique or rare circumstances, they reaffirm the strength of multiple case designs as it is through them that better accuracy and generalization can be reached.

Likewise, Robert Yin emphasizes the importance of variables, triangulation in the search for “truth” and generalizable theoretical propositions. Yin (2015 , p. 18) suggests that the case study method may be appropriate for different epistemological orientations, although much of his work seems to invoke a realist epistemology. Authors such as Merrian (2009) and Stake (2003) suggest an interpretative version of case studies. Stake (2003) looks at cases as a qualitative option, where the most relevant criterion of case selection should be the opportunity to learn and understand a phenomenon. A case is not just a research method or strategy; it is a researcher’s choice about what will be studied:

Even if my definition of case study was agreed upon, and it is not, the term case and study defy full specification (Kemmis, 1980). A case study is both a process of inquiry about the case and the product of that inquiry ( Stake, 2003 , p. 136).

Later, Stake (2003 , p. 156) argues that:

[…] the purpose of a case report is not to represent the world, but to represent the case. […] The utility of case research to practitioners and policy makers is in its extension of experience.

Still according to Stake (2003 , pp. 140-141), to do justice to complex views of social phenomena, it is necessary to analyze the context and relate it to the case, to look for what is peculiar rather than common in cases to delimit their boundaries, to plan the data collection looking for what is common and unusual about facts, what could be valuable whether it is unique or common:

Reflecting upon the pertinent literature, I find case study methodology written largely by people who presume that the research should contribute to scientific generalization. The bulk of case study work, however, is done by individuals who have intrinsic interest in the case and little interest in the advance of science. Their designs aim the inquiry toward understanding of what is important about that case within its own world, which is seldom the same as the worlds of researchers and theorists. Those designs develop what is perceived to be the case’s own issues, contexts, and interpretations, its thick descriptions . In contrast, the methods of instrumental case study draw the researcher toward illustrating how the concerns of researchers and theorists are manifest in the case. Because the critical issues are more likely to be know in advance and following disciplinary expectations, such a design can take greater advantage of already developed instruments and preconceived coding schemes.

The aforementioned authors were listed to illustrate differences and sometimes opposing positions on case research. These differences are not restricted to a choice between positivism and interpretivism. It is worth noting that Ragin’s (2013 , p. 523) approach to “casing” is compatible with the realistic research perspective:

In essence, to posit cases is to engage in ontological speculation regarding what is obdurately real but only partially and indirectly accessible through social science. Bringing a realist perspective to the case question deepens and enriches the dialogue, clarifying some key issues while sweeping others aside.

cases are actual entities, reflecting their operations of real causal mechanism and process patterns;

case studies are interactive processes and are open to revisions and refinements; and

social phenomena are complex, contingent and context-specific.

Ragin (2013 , p. 532) concludes:

Lurking behind my discussion of negative case, populations, and possibility analysis is the implication that treating cases as members of given (and fixed) populations and seeking to infer the properties of populations may be a largely illusory exercise. While demographers have made good use of the concept of population, and continue to do so, it is not clear how much the utility of the concept extends beyond their domain. In case-oriented work, the notion of fixed populations of cases (observations) has much less analytic utility than simply “the set of relevant cases,” a grouping that must be specified or constructed by the researcher. The demarcation of this set, as the work of case-oriented researchers illustrates, is always tentative, fluid, and open to debate. It is only by casing social phenomena that social scientists perceive the homogeneity that allows analysis to proceed.

In summary, case studies are relevant and potentially compatible with a range of different epistemologies. Researchers’ ontological and epistemological positions will guide their choice of theory, methodologies and research techniques, as well as their research practices. The same applies to the choice of authors describing the research method and this choice should be coherent. We call this research alignment , an attribute that must be judged on the internal coherence of the author of a study, and not necessarily its evaluator. The following figure illustrates the interrelationship between the elements of a study necessary for an alignment ( Figure 1 ).

In addition to this broader aspect of the research as a whole, other factors should be part of the researcher’s concern, such as the rigor and quality of case studies. We will look into these in the next section taking into account their relevance to the different epistemologies.

4. Rigor and quality in case studies

Traditionally, at least in positivist studies, validity and reliability are the relevant quality criteria to judge research. Validity can be understood as external, internal and construct. External validity means identifying whether the findings of a study are generalizable to other studies using the logic of replication in multiple case studies. Internal validity may be established through the theoretical underpinning of existing relationships and it involves the use of protocols for the development and execution of case studies. Construct validity implies defining the operational measurement criteria to establish a chain of evidence, such as the use of multiple sources of evidence ( Eisenhardt, 1989 ; Yin, 2015 ). Reliability implies conducting other case studies, instead of just replicating results, to minimize the errors and bias of a study through case study protocols and the development of a case database ( Yin, 2015 ).

Several criticisms have been directed toward case studies, such as lack of rigor, lack of generalization potential, external validity and researcher bias. Case studies are often deemed to be unreliable because of a lack of rigor ( Seuring, 2008 ). Flyvbjerg (2006 , p. 219) addresses five misunderstandings about case-study research, and concludes that:

[…] a scientific discipline without a large number of thoroughly executed case studies is a discipline without systematic production of exemplars, and a discipline without exemplars is an ineffective one.

theoretical knowledge is more valuable than concrete, practical knowledge;

the case study cannot contribute to scientific development because it is not possible to generalize on the basis of an individual case;

the case study is more useful for generating rather than testing hypotheses;

the case study contains a tendency to confirm the researcher’s preconceived notions; and

it is difficult to summarize and develop general propositions and theories based on case studies.

These criticisms question the validity of the case study as a scientific method and should be corrected.

The critique of case studies is often framed from the standpoint of what Ragin (2000) labeled large-N research. The logic of small-N research, to which case studies belong, is different. Cases benefit from depth rather than breadth as they: provide theoretical and empirical knowledge; contribute to theory through propositions; serve not only to confirm knowledge, but also to challenge and overturn preconceived notions; and the difficulty in summarizing their conclusions is because of the complexity of the phenomena studies and not an intrinsic limitation of the method.

Thus, case studies do not seek large-scale generalizations as that is not their purpose. And yet, this is a limitation from a positivist perspective as there is an external reality to be “apprehended” and valid conclusions to be extracted for an entire population. If positivism is the epistemology of choice, the rigor of a case study can be demonstrated by detailing the criteria used for internal and external validity, construct validity and reliability ( Gibbert & Ruigrok, 2010 ; Gibbert, Ruigrok, & Wicki, 2008 ). An example can be seen in case studies in the area of information systems, where there is a predominant orientation of positivist approaches to this method ( Pozzebon & Freitas, 1998 ). In this area, rigor also involves the definition of a unit of analysis, type of research, number of cases, selection of sites, definition of data collection and analysis procedures, definition of the research protocol and writing a final report. Creswell (1998) presents a checklist for researchers to assess whether the study was well written, if it has reliability and validity and if it followed methodological protocols.

In case studies with a non-positivist orientation, rigor can be achieved through careful alignment (coherence among ontology, epistemology, theory and method). Moreover, the concepts of validity can be understood as concern and care in formulating research, research development and research results ( Ollaik & Ziller, 2012 ), and to achieve internal coherence ( Gibbert et al. , 2008 ). The consistency between data collection and interpretation, and the observed reality also help these studies meet coherence and rigor criteria. Siggelkow (2007) argues that a case study should be persuasive and that even a single case study may be a powerful example to contest a widely held view. To him, the value of a single case study or studies with few cases can be attained by their potential to provide conceptual insights and coherence to the internal logic of conceptual arguments: “[…] a paper should allow a reader to see the world, and not just the literature, in a new way” ( Siggelkow, 2007 , p. 23).

Interpretative studies should not be justified by criteria derived from positivism as they are based on a different ontology and epistemology ( Sandberg, 2005 ). The rejection of an interpretive epistemology leads to the rejection of an objective reality: “As Bengtsson points out, the life-world is the subjects’ experience of reality, at the same time as it is objective in the sense that it is an intersubjective world” ( Sandberg, 2005 , p. 47). In this event, how can one demonstrate what positivists call validity and reliability? What would be the criteria to justify knowledge as truth, produced by research in this epistemology? Sandberg (2005 , p. 62) suggests an answer based on phenomenology:

This was demonstrated first by explicating life-world and intentionality as the basic assumptions underlying the interpretative research tradition. Second, based on those assumptions, truth as intentional fulfillment, consisting of perceived fulfillment, fulfillment in practice, and indeterminate fulfillment, was proposed. Third, based on the proposed truth constellation, communicative, pragmatic, and transgressive validity and reliability as interpretative awareness were presented as the most appropriate criteria for justifying knowledge produced within interpretative approach. Finally, the phenomenological epoché was suggested as a strategy for achieving these criteria.

From this standpoint, the research site must be chosen according to its uniqueness so that one can obtain relevant insights that no other site could provide ( Siggelkow, 2007 ). Furthermore, the view of what is being studied is at the center of the researcher’s attention to understand its “truth,” inserted in a given context.

The case researcher is someone who can reduce the probability of misinterpretations by analyzing multiple perceptions, searches for data triangulation to check for the reliability of interpretations ( Stake, 2003 ). It is worth pointing out that this is not an option for studies that specifically seek the individual’s experience in relation to organizational phenomena.

In short, there are different ways of seeking rigor and quality in case studies, depending on the researcher’s worldview. These different forms pervade everything from the research design, the choice of research questions, the theory or theories to look at a phenomenon, research methods, the data collection and analysis techniques, to the type and style of research report produced. Validity can also take on different forms. While positivism is concerned with validity of the research question and results, interpretivism emphasizes research processes without neglecting the importance of the articulation of pertinent research questions and the sound interpretation of results ( Ollaik & Ziller, 2012 ). The means to achieve this can be diverse, such as triangulation (of multiple theories, multiple methods, multiple data sources or multiple investigators), pre-tests of data collection instrument, pilot case, study protocol, detailed description of procedures such as field diary in observations, researcher positioning (reflexivity), theoretical-empirical consistency, thick description and transferability.

5. Conclusions

The central objective of this article was to discuss concepts of case study research, their potential and various uses, taking into account different epistemologies as well as criteria of rigor and validity. Although the literature on methodology in general and on case studies in particular, is voluminous, it is not easy to relate this approach to epistemology. In addition, method manuals often focus on the details of various case study approaches which confuse things further.

Faced with this scenario, we have tried to address some central points in this debate and present various ways of using case studies according to the preferred epistemology of the researcher. We emphasize that this understanding depends on how a case is defined and the particular epistemological orientation that underpins that conceptualization. We have argued that whatever the epistemological orientation is, it is possible to meet appropriate criteria of research rigor and quality provided there is an alignment among the different elements of the research process. Furthermore, multiple data collection techniques can be used in in single or multiple case study designs. Data collection techniques or the type of data collected do not define the method or whether cases should be used for theory-building or theory-testing.

Finally, we encourage researchers to consider case study research as one way to foster immersion in phenomena and their contexts, stressing that the approach does not imply a commitment to a particular epistemology or type of research, such as qualitative or quantitative. Case study research allows for numerous possibilities, and should be celebrated for that diversity rather than pigeon-holed as a monolithic research method.

The interrelationship between the building blocks of research

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The most-read case studies of 2021, and the profs who wrote them.

Debapratim Pukayastha of ICFAI Business School in India topped the Case Centre’s list of the world’s top case studies for the sixth straight year. Sadly, Pukayastha passed away in May from Covid-19.

Harvard Business School, which invented both the first MBA program and the business case method, remains king of the case study 100 years later, according to the latest international ranking of case authors.

The Case Centre, a nonprofit that distributes the largest collection of management case studies to business schools across the world, today (October 25) unveiled its 2020-21 Top 50 Bestselling Case Authors. HBS had more case authors (nine) on the list than any other business school. However, ICFAI Business School in India was close behind with seven authors, including all three top individual spots. INSEAD had four authors in the top 10, while Harvard has two top-10 authors.

Case studies, which use real-life problems faced by business executives, are still one of the most widely used education tools for MBA students across the globe. More than 8,800 faculty are registered as authors with The Case Centre. This year’s list of best-selling cases includes each author’s top-selling cases — and though MBA students may not recognize the names of a case study’s author, the titles are more likely ring a bell.

SIX YEARS AT NO. 1, BUT A POSTHUMOUS HONOR

Debapratim Pukayastha of ICFAI Business School (IBS) in India topped the Case Centre’s list of bestselling authors for the sixth straight year. He has earned the distinction every year since the Case Centre began issuing yearly awards for case writing. But this year’s award was a bittersweet honor, as Pukayastha passed away in May from Covid-19.

“Selling over 100,000 copies from an extensive back catalogue of cases since the list was introduced in 2016, Debapratim’s undoubted impact on the case method and management education will live on for years through the many case authors and teachers he has inspired,” the Case Centre announced, “and the vast number of students whose education has been enhanced by learning through his cases.”

Among Pukayastha’s best-selling cases are an examination of safety lapses at a BP oil refinery in Texas City that led to one of the most serious workplace accidents in U.S. history; a case looking at Netflix’s leveraging of Big Data to predict hits; and a case examining how Procter & Gamble develops new products. Besides his annual plaudits for bestselling case, he also won the Case Centre’s Outstanding Contribution to the Case Method Award in 2015, 2018, and 2019.

“I believe that one can be a good teacher without being a good case writer, but it’s not possible to be a good case writer without being a good teacher,” Pukayastha wrote in an author profile on the Case Centre website . “However, I have also found that regularly writing cases can greatly improve classroom teaching. Case writing can be a lonely activity and even hard work, but if you have the passion, it’s worth it! It means you can have a positive impact in classrooms around the world where your case is taught.”

This infographic from The Case Centre shows the key demographic trends in the 2020/21 Top Bestselling Case Authors ranking. Courtesy Case Centre

WHERE TO TOP B-SCHOOL CASE STUDIES COME FROM

The UK- and U.S.-based Case Centre has released its bestselling case author list every year since 2016, ranking authors whose cases have sold the most copies during the previous academic year. This year, it raised the number of bestselling authors from 40 to 50.

Of this year’s list, authors came from 19 different business schools in nine separate countries. That includes 42% each from Europe and the United States, and 16% from Asia.

“As the list increases from 40 to 50, we see a change in the geographic dynamics,” the nonprofit announced. “European and U.S. schools each have a 42% share of the 2020/21 Top 50, down from 45% in 2019-20. While the representation of schools in Asia rises to 16%, up from 10% last year.”

Eighteen percent of the authors are women while 82% are men. While the list does not break down bestselling cases by the race, ethnicity or gender of its protagonists, finding case studies that represent the increasing diversity of business students (and in business executives) has been an ongoing concern for many B-schools’ diversity, equity, and inclusion efforts. For example, Harvard Business School published more than 70 cases with Black or African-American protagonists this past year after long-standing criticism that its studies ignored Black business leaders, according to a Poets&Quants article published in June .

It also produced 90 cases featuring Hispanic, Asian or Asian-American/Pacific Islander, or Native-American protagonists. HBS faculty write about 400 case studies per year.

“Our students are right that protagonist diversity matters,” Jan Rivkin, HBS senior associate dean and chair of the MBA program, said in June . “By studying cases with a wide diversity of protagonists, students learn that talent and leadership come from all backgrounds and identities. If students don’t understand that, they’ll worsen inequities, miss out on opportunities for themselves, and miss chances to create opportunities for others.”

DEBUT AUTHORS EARN TOP SPOTS

ICFAI Business School also had the No. 2 and No. 3 authors, and both are new entrants to the Case Centre’s list.

Second-ranked author Indu Perepu is an assistant professor specializing in human resource management. Her best-selling cases include “Airbnb: A Disruptive Innovator” and “Snapchat Turns Down Facebook’s Acquisition Offer.”

“What makes the case study method even more meaningful is that in developing countries like India where teaching through cases is picking up, case studies help the students with limited international exposure to learn intricately about multinational corporations and the world’s largest companies,” Perepu says.

Third-ranked author Syeda Maseeha Qumer is an assistant professor specializing in business strategy. For her top-selling cases, she looked at the integrated marketing strategy of HBO’s Game of Thrones and the impact of conflict palm oil on deforestation, human rights violations, and climate pollution, and PepsiCo’s use of it in its products.

“Case-based learning is unmatched in its ability to engage students and teach essential concepts that are relevant to practicing managers,” Qumer says. “Innovation in the case method is essential to enliven any classroom and to obtain better learning outcomes. I have always endeavored to develop diverse cases on contemporary issues that offer students an opportunity to explore complex real-world management challenges in the classroom, allowing them to assess their decision-making skills before taking the plunge into the corporate world.”

France’s ESSEC Business School had the top climbing author, Ashok Som , who moved up 26 places to No. 11 from last year’s ranking.

See the full list of this year’s case-writing winners on page 2, including links to their bios.

Harvard Business School is the home of the business case study. Once again it is also where most of the top-ranked cases were written in 2021

Beyond its ranking of case study authors, the Case Centre trains faculty in using case studies in B-school education, runs international case competitions and offers scholarships to unpublished case writers and teachers. Membership includes more than 500 business schools and organizations around the world.

See its full release and read about other best-selling authors here .

1. The Top 50 Bestselling Case Authors 2020/21 – full list

1 Debapratim Purkayastha , ICFAI Business School (IBS) 2 Indu Perepu , ICFAI Business School (IBS) 3 Syeda Maseeha Qumer , ICFAI Business School (IBS) 4 W Chan Kim , INSEAD (joint) 4 Renée Mauborgne , INSEAD (joint) 6 Joerg Niessing , INSEAD 7 Christopher A Bartlett , Harvard Business School 8 Wolfgang Ulaga , INSEAD 9 David B Yoffie , Harvard Business School 10 Nader Tavassoli , London Business School 11 Ashok Som , ESSEC Business School 12 Jill Avery , Harvard Business School 13 Kamran Kashani , Institute for Management Development (IMD) 14 Youngme Moon , Harvard Business School 15 Kasra Ferdows , McDonough School of Business, Georgetown University 16 John A Quelch , Miami Business School 17 David Dubois , INSEAD 18 Carlos Cordon , Institute for Management Development (IMD) 19 Michael Lewis , University of Bath School of Management (joint) 19 Jose A D Machuca , Universidad de Sevilla (joint) 21 David J Collis , Harvard Business School 22 Pierre Chandon , INSEAD 23 Mohanbir Sawhney , Kellogg School of Management 24 Robert F Bruner , University of Virginia Darden School of Business 25 Denis Gromb , HEC Paris 26 Urs Mueller , SDA Bocconi School of Management 27 Vivek Gupta , TechSci Research 28 Jamie Anderson , Antwerp Management School 29 Benoit Leleux , Institute for Management Development (IMD) 30 Sanjib Dutta , ICFAI Business School (IBS) 31 Vincent Dessain , Harvard Business School 32 GV Muralidhara , ICFAI Business School (IBS) 33 Jitesh Nair , ICFAI Business School (IBS) 34 Michael J Schill , University of Virginia Darden School of Business 35 Elizabeth Grasby , Ivey Business School 36 Horacio Falcão , INSEAD 37 Robert S Kaplan , Harvard Business School 38 Seán A Meehan , Institute for Management Development (IMD) 39 Herminia Ibarra , London Business School 40 Ian Dunn , Ivey Business School 41 Peter Killing , Institute for Management Development (IMD) 42 Stefan Michel , Institute for Management Development (IMD) 43 Jan W Rivkin , Harvard Business School 44 Inyoung Chae , Goizueta Business School, Emory University 45 Sean D Carr , University of Virginia Darden School of Business 46 James E Hatch , Ivey Business School 47 Thales Teixeira , Decoupling.co 48 Eric Van den Steen , Harvard Business School 49 V Namratha Prasad , ICFAI Business School (IBS) 50 P Fraser Johnson , Ivey Business School

DON’T MISS HOW TO REVIEW MBA CASE STUDIES LIKE AN EXECUTIVE and HARVARD BUSINESS SCHOOL FACULTY PUBLISHED 70 CASES WITH BLACK PROTAGONISTS THIS PAST YEAR

The post The Most-Read Case Studies Of 2021, And The Profs Who Wrote Them appeared first on Poets&Quants .

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The Woman Behind Freud’s First Case Study

The case of anna o. showed that psychoanalysis worked. did freud tamper with it.

There is perhaps no one more devoted to the cause than a convert, and there is no one more violent toward it than a person who has lost their faith. The faithful turned faithless take up the act of crusade, but in reverse: new atheists confronting the world with secular eyes, children who learn that their parents aren’t omnipotent. They have suffered the loss of an organizing principle, the very thing they built their life around. Now, they may seek revenge on the object that caused an earlier delusion. The commitment doesn’t end—it just takes on new guises.

Beyond the reactions of former lovers and former zealots, we see this in the history of psychoanalysis, perhaps because the practice attracts and demands those same qualities of immersion and devotion. Many have justly loved psychoanalysis, and many have justly despaired of it. This includes the very founders of rational emotive behavioral therapy and cognitive behavioral therapy, who brought about a sea change in mental health care, and the critics Frederick Crews, Jeffrey Masson, and Philip Rieff, who turned against Freud even after he had been unthroned as king of the twentieth century. This hatred can feel quasi-personal, aimed at the originator, their father figure, Sigmund Freud.

This loss of faith looms over Gabriel Brownstein’s book, The Secret Mind of Bertha Pappenheim: The Woman Who Invented Freud’s Talking Cure . On its face, the book is a study of the first analytic patient (although she didn’t exactly receive psychoanalytic treatment), Bertha Pappenheim. Pappenheim, who was treated by Freud’s mentor Josef Breuer in Vienna, was the subject of one of Breuer’s case studies and was much discussed by Freud throughout his own career. The book’s stated aim is to offer a full portrait of someone flattened and circulated as a specimen. For Pappenheim is best known by another name—Anna O.—and is best known not as her full person, who left a legacy of feminist and activist patronage, but as the world’s most famous hysteric.

But quietly, this is also a book about the birth and death of psychoanalysis—which is to say that the narrative of Freud’s ascendance and betrayal is the engine that drives the book. Brownstein argues, sometimes contradictorily, that Freud’s brilliance and his drive to make his way as a medical doctor propelled him to tamper with Bertha’s story.

Given that Pappenheim’s stunning cure is the origin story of psychoanalysis, Brownstein seeks to denigrate the whole endeavor on these grounds. If the Anna O. case was a fraud, so, too, would the cure be that she discovered.

Hysteria, much like psychoanalysis, has a storied past, one with a powerful crescendo followed by a caesura. Though the term “hysteric” is now assumed in common speech to be either a pejorative epithet, synonymous with performative hyper-emotionality ( he was hysterical ), or a historical diagnosis made up by misogynistic doctors (like, some argue, Breuer and Freud), the condition was once quite common. For the uninitiated, hysteria is an illness where the body speaks, where neurotic symptoms appear in and on it. It was treated by an array of cures, from gynecological massage (prescribed orgasm), hypnotism, rest, and drugging, to change of scenery, and, yes, for a very few patients, starting in the late nineteenth century, Breuer and Freud’s cathartic method. This eventually became psychoanalysis. This was, it must be said, a treatment that seems preferable to the other options.

Bertha Pappenheim was in many ways a typical hysterical patient, and an extraordinary woman. When she went to see Breuer in 1880, she presented with the typical hysterical complaints: partial paralysis, disturbances of appetite and language, pain. She couldn’t recall her native German and only spoke in English. She wouldn’t drink water. She had fallen ill while nursing her father, and her condition deteriorated upon his death. She was treated both in her home and in an asylum, often with high doses of drugs. What marks her case as special is that Pappenheim was the first person on Earth to be treated by the cathartic method, in large part because she invented it. Anytime you hear someone say “talking cure,” they’re using the very term Pappenheim ascribed to the yearslong experiment she undertook, morning and night, with her doctor. As she chattered on, as she engaged in the “chimney sweeping” of her mind—so the story goes—she felt better.

Freud and Breuer went on to co-write the groundbreaking Studies on Hysteria , published in 1895. The two doctors, one senior and one junior, open the book with a co-written introduction and end it with a pair of stand-alone essays (Freud’s undermining Breuer’s) in which the nascent theories of repression, defense, catharsis, and abreaction first appear. Each supplied case material of hysteric women treated by this nascent cathartic method. Freud wrote up four cases, and Breuer only contributed the case of Pappenheim, now disguised and named “Anna O.” The two detailed the symptoms of their patients and how each was aided, if not outright cured, by this new talking protocol.

In Breuer’s write-up of Anna O., which only runs about 25 pages, he elaborates on the case study, telling his readers how ill Anna was, when, and why. He then goes on to describe his therapeutic practice of sitting with her at night, and how, while Anna O. was under hypnosis, the two came to “develop a therapeutic technique” of linking each of her symptoms to the moment it appeared. The water she will not drink, for instance, is linked to a moment she saw her English ladies’ companion let a little dog drink from her glass. After the connection is revealed under hypnosis, Breuer tells us, Anna O. drinks water once more. The process repeated until there were no symptoms left, and Anna O.’s mental state presumably returned to normal.

The problem is—and basically all historians of psychoanalysis agree on this point—that even though Breuer and Freud reported a miracle cure, Anna O. didn’t get better. In fact, she got worse and was put in a sanatorium. The question is why. Brownstein, following the anti-Freud tradition, attributes this failure to the treatment. Freud, of course, attributed this failure to the person who offered the treatment—Breuer—not because he couldn’t cure her, but because he didn’t finish doing so.

Like all origin myths, the case has been subject to endless interpretation and reinterpretation. Even the original case study is retrospective: Breuer didn’t write up the Anna O. case at the time of treatment. He did so at Freud’s urging, so that the two might document this new technique of psychotherapy. Anna O. thus became the first patient of psychoanalysis only after the fact, and even though her treatment has just about nothing in common with psychoanalysis today, she is celebrated as such. Freud then revised the case multiple times across his life (in private letters, then in publications in 1910 and 1914), often to diminish Breuer’s role in the origin of psychoanalysis. This is in part due to what Freud thought of privately as Breuer’s failure: When Anna O. showed Breuer she had transferred onto him—by fantasizing about having his baby—Breuer ran away. Breuer could have invented psychoanalysis had he stayed in the room—but he didn’t dare. And thus Anna remained ill, but, in Freud’s understanding, psychoanalysis was not at fault.

Once Freud died, others revised the case in their own ways. Stacks of books can be called up in any research library by those who either defend or revile Freud—and nearly all of them, at one point, turn to Anna O. These studies often seek to collate and correlate Breuer’s flattened write-up of the case with historical reality, trying to reconstruct both Anna O.’s illness and her medical treatment. Some are feminist rereadings of the case, arguing that Anna O. was sick with patriarchy; others center squarely on Freud’s obsession with the case, excavating his letters about Anna O. to various ends.

What’s plain as day: Pappenheim has become the Rorschach test for the field. What we see in her case tends to be run through our feelings about psychoanalysis. The great historian of psychoanalysis John Forrester has argued that the baby that Anna O. spoke of wanting to have with Breuer was psychoanalysis—something she conceived with Breuer, even though he wouldn’t stick around and take responsibility for it. Anti-Freudian Mikkel Borch-Jacobsen sees Anna O.’s case as entirely fabricated, a young woman taken in by her handsome doctor and given huge quantities of drugs; if she invented psychoanalysis, she was the first to be duped by it. As the late Peter Gay observed, “There are contradictions and obscurities in successive versions of the case, but this much is more or less beyond dispute: In 1880, when Anna O. fell ill, she was twenty-one.”

But because very little besides Breuer’s documents is known of her life at the time of treatment, we project what we want onto her, and we can, for her history is a mere fragment. That we continue to do so makes exquisite sense: Psychoanalysis teaches us we must go back to our origins to go forward. And the treatment of Anna O. by Breuer is one way—a decent way—to conceptualize the start of Freud’s theory of mind.

Brownstein’s main critique of Freud’s use of Anna O. is this: that he took her case for his own material ends (though, by the same token, we might ask after Brownstein’s book advance). Freud was a broke young doctor; he needed to get married, and, to do so, he needed to press Breuer into writing Studies on Hysteria so that he could practice this new treatment with a kind of paternal authorization, styling himself as a doctor of “the cathartic method of J. Breuer.”

Brownstein agrees with anti-Freudians like Borch-Jacobsen and Crews that Anna O.’s treatment was a dismal failure. And even though that would make the lie—that Anna O. was cured—Breuer’s, Brownstein argues it was Freud who metaphorically had a gun to his mentor’s head and forced him to write it. More softly, Brownstein argues that Anna O. obscures Bertha Pappenheim, whom Brownstein now promises to deliver to us. Here’s the problem: Brownstein wants to make Freud the (very) bad guy of a story that had little to do with him, even if he had a great deal to do with the case becoming a story. So much so that Brownstein treats the possibility of Freud seeing Bertha Pappenheim at a party years after the treatment as corroborating evidence for some kind of misdeed.

Brownstein thus rewrites up the notorious case, with his chatty, negative asides and interpretations taking center stage. His first close reading from the book is, appropriately, from the first page. He argues that, though Studies purports to be “about the sex lives and sex drives of young bourgeois women,” it “begins by announcing that, for the purposes of propriety, any discussion of their actual intimate lives will be avoided.” Brownstein argues that this is a cover—that Breuer and Freud are maliciously withholding evidence for their theory because there isn’t any and because the doctors wanted to appear respectable. But if we read the first page of Studies , here’s what Breuer and Freud actually wrote: “It would be a grave breach of confidence to publish material of this kind, with the risk of patients being recognized and their acquaintances becoming informed of facts which were confided only to the physician.” There is a deep truth to what Freud and Breuer argue: They were working in a small coterie of largely wealthy Viennese Jewish patients. Everyone knew one another (hence, the great possibility of Freud running into Pappenheim). If you circulated reports of the ills of a young woman’s “marriage bed” or lack thereof, it would have meant no father would refer his daughter to Breuer or Freud, let alone the greater ethical considerations Brownstein says are gestured to half-heartedly.

Elsewhere, Brownstein accuses Freud of having a faulty memory and disguising the patient (despite the authors’ own opening warning to the reader not to go looking for biographical information of Pappenheim). To cover over the lack of details about her, Brownstein freely narrativizes the case, turning it into a historical fiction. At other times, Brownstein seems furious that Freud tends to write beautifully—Brownstein takes this as a sign of fudging the facts—while he then turns to close reading it like a literary critic.

By the end, we know from Brownstein that we’re supposed to find Breuer largely unobjectionable, but in the grips of a young Freud. The cardinal sin for Brownstein, though, is that Anna O. wasn’t made better. (Brownstein believes that she was in fact suffering from a functional neurological disorder, a contemporary diagnosis that overlaps with hysteria.) She was transported back to the asylum, so ill that Breuer reportedly told Freud his beloved patient might be better off dead, so that she might be free of suffering. Yet we might pause and say something did indeed happen in that treatment: Pappenheim was ultimately able to recover enough. By 1889, at 29 years of age, she was able not only to get out of bed, to talk, but to work in a soup kitchen. From this year on, she published—first anonymously and then pseudonymously, under the name Paul Berthold. Soon, Pappenheim was finally known not as Anna O., not as Berthold, but as herself. She also became famous as herself, a powerful, feminist leader, founding the Jewish Women’s Association and centralizing Jewish women’s organizing toward both employment and charity.

Why a book about Bertha Pappenheim now? One answer: With its claim that it will deliver readers Pappenheim in full, Brownstein’s book sits on that ever-expanding shelf of nonfiction books that seek to tell the stories of women who have been relegated to the margins of history, returning them to their larger, unobfuscated import. The book, too, in trying to bring Pappenheim’s story up to the present by rediagnosing her with functional neurological disorder, joins the book market for explorations of contested illness. Yet this book isn’t exactly proper to either of these subgenres. Instead, we might make sense of it as a work of backlash: Just as a range of analysts and writers have turned once more to Freud (as The New York Times proclaimed in an article not quite aptly titled “Not Your Daddy’s Freud”), so have others returned to maligning him. Brownstein has offered us, perhaps, the first book of the Freud Wars 2.0.

Brownstein, in fact, inherits the role of Freud skeptic from an earlier generation. His father, Dr. Shale Brownstein, was a prominent New York psychiatrist and psychoanalyst with a Rolodex of famous patients. Sometime in the 1980s, Dr. Brownstein became disillusioned with psychoanalysis and became an anti-Freudian—though we are never quite told why. One night, when Brownstein went to visit his father, he found him in his underwear, speaking wildly. The subject: Bertha Pappenheim. His father held a thick envelope filled with scientific and historic papers, newspaper clippings, reviews of books, and his own essay on the subject.

His father gave him the manila envelope. The younger Brownstein went home to Brooklyn, and the next day his father was dead. As if in a novel, Brownstein then becomes fixated on the envelope and its contents only to discover he has misplaced it. His own book is as much an attempt to decipher his father’s theory about Bertha Pappenheim as to understand his father’s turn against Freud. Brownstein makes clear that his father was a devoted doctor, and treated luminaries in downtown New York, including Peter Hujar and Richard Serra. Dr. Brownstein tended to babies with HIV in the 1980s who languished otherwise in their cots, when others wouldn’t dare go near. Dr. Brownstein gave everything to psychoanalysis, but then something changed. We don’t quite know what, but his father became so disillusioned that he burned all 24 volumes of Freud’s Standard Edition .

Was it the homophobia of mainstream psychoanalysis that rightfully made him repudiate his training? Was it indeed the legacy of Anna O.? I wish we knew what Brownstein felt as he wrestled with Freud via his father. As author and son, Brownstein is overwhelmed by the research subject he must now try to understand and, more importantly, terribly overwhelmed by the pain of being alive when life is most brutal. Shortly after his father’s death, his wife is diagnosed with terminal pancreatic cancer, and when the global pandemic arrives, Brownstein must weather it without them.

While Brownstein seemingly hates Freud, he, like many others, can’t escape him. Early in the book, he disparages two Freudian terms: “secondary gain,” which can be described as the unconscious advantage patients acquire through their illness (stereotyped here as attention), and “ la belle indifférence ,” a calm character in the face of crisis. But toward the book’s close, Brownstein suddenly tips his hand: He comes to a form of self-understanding through these concepts. In not getting treated for a heart problem, he says he has a case of la belle indifférence . In writing the book, he self-analyzes, he can be understood as having a case of secondary gain—after all, Brownstein was quite literally paid for producing it.

But Brownstein uses these concepts defensively—to show his reader he is in on the joke. The book itself, more movingly, is a testament to yet another set of Freudian concepts: the return of the repressed, as evidenced by his return to the use of Freud; working through (here, loss of his father, his wife); and, indeed, sublimation. Writing the book then might be an act of Freudian sublimation; it is also an act of devotion. This article has been updated.

Hannah Zeavin is an assistant professor of history at UC Berkeley. She is the author of The Distance Cure: A History of Teletherapy .

Knowing when to call it quits takes courage and confidence - 3 case studies

Professor of Political Science, Trinity College

Chairperson and Associate Professor of Law, College of Staten Island, CUNY

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After President Joe Biden’s disastrous performance at the June 27, 2024, debate, many Democrats have raced to ring the alarm bell, proclaiming that it’s time for him to step aside, time to let someone else take the reins in hopes of defeating Donald Trump in November.

With that in mind, as political scientists with a side interest in sports, we recount three moments from history when men and women faced the difficult decision to stay or go. We hope they will help inform the current discussion.

We begin with two who worked at the highest levels of power in the U.S.:

President Lyndon Johnson, 1968

On the final night of March 1968, President Lyndon B. Johnson, known universally as “LBJ,” spoke to the nation from the Oval Office to say that the United States would unilaterally halt nearly all its bombing in North Vietnam.

But as his address came to a close, he had something more to say:

Shocking his audience, LBJ added : “I shall not seek, and I will not accept, the nomination of my party for another term as your president.”

Johnson was 59 years old. Three-and-a-half years earlier, he had scored one of the greatest landslides in American history, winning 61% of the vote and 44 states in the 1964 presidential election .

A scant few individuals so aptly defined the term “political animal” as LBJ. He had come to Washington as a young man bursting with ambition and succeeded like few others.

Indeed, since becoming president after John F. Kennedy’s 1963 assassination , Johnson had ushered through Congress an avalanche of progressive legislation , including the historic 1964 Civil Rights and 1965 Voting Rights acts. With the possible exception of Franklin D. Roosevelt, no other president had achieved so much legislatively.

But on that March day in 1968, at a time of growing antiwar protests and the accelerating pull of rival candidates for the Democratic nomination, he understood that he now led a country coming apart at the seams. Despite having declared his candidacy for reelection, seeking another term might make things worse.

It was time for someone else to have a turn.

Justice Ruth Bader Ginsburg, 2013

As one of us recounts in his book, “ A Supreme Court Unlike Any Other: The Deepening Divide Between the Justices and the People ,” President Barack Obama invited Justice Ruth Bader Ginsburg for a private lunch at the White House in the summer of 2013.

Obama wanted to nudge Ginsburg into retirement. The 80-year-old justice was a two-time survivor of pancreatic cancer, one of the deadliest of all cancers. She had already served on the high court for two decades and had carved out a legacy as a staunch liberal and champion of women’s equality.

Additionally, Obama was concerned about the upcoming midterm elections. If the Democrats lost the Senate, he would not be able to replace her with a like-minded justice, because a GOP-run Senate would not confirm such a nominee.

Ginsburg didn’t take Obama’s hint.

Soon after the lunch, she noted, “ I think one should stay as long as she can do the job .” She added shortly after , “There will be a president after this one, and I’m hopeful that that president will be a fine president.”

That next president was Donald Trump.

Ginsburg died in mid-September 2020, just weeks before Joe Biden would oust Trump from the White House. But significantly, Trump had sufficient time to fill Ginsburg’s seat with the conservative Amy Coney Barrett .

In 2022, Barrett provided the fifth and decisive vote in the Dobbs decision, which overturned Roe v. Wade’s federal protection of abortion rights .

Deciding when to step away or stay may have deep consequences in the political world.

The consequences are big in sports, as well, but at a more personal level.

Philadelphia Eagle Jason Kelce, 2024

Skeptics said he was too small to play among the giants on an offensive line in the NFL. Not strong enough. Not tough enough. A former walk-on who had been drafted in 2011 in the sixth round .

But in a short space of time, Jason Kelce redefined the position of center and helped guide his team to its first-ever Super Bowl win.

In 2024, Kelce’s team, the Philadelphia Eagles, was still one of the best in the NFL. It had been to the Super Bowl just a year earlier, and Kelce was still considered to be playing near the top of his game.

But Kelce had had enough. It was time for him to end his playing days.

Sitting before a packed room of reporters and family members, the bare-armed and burly-chested 36-year-old Kelce set out to say goodbye .

But before he could even get a sentence out, his emotions took over, forcing him to pause for several moments. He held his head in his hands, sobbing, sniffling, snorting, taking deep breaths. Tears streamed down his face throughout the news conference. Repeatedly, he had to stop and wipe them away with a washcloth someone tossed to him.

As he struggled to get through his statement, listeners could hear him motivate himself several times with the phrase, “Come on.”

The ‘courage to call it quits’

Kelce’s retirement announcement is both difficult and extraordinarily captivating to watch. During those 40 minutes, he displays the courage it takes to call it quits when there is still something to be gained.

The picture was of a man coming to terms with his fate. Not because of injury or lack of skill, but because he believed it was necessary to take this step before those things forced him out.

Are there moments when we can judge for another when it is time to bow out? Most assuredly, there are. Hopefully, we do so with compassion and gratitude, but there are simply times when conscience demands an honest reckoning and unflinching truth-telling.

• Lyndon Baines Johnson
• Voting Rights Act
• US Constitution
• Political conventions
• US presidency
• Mental ageing
• 25th Amendment
• Philadelphia Eagles
• Civil Rights Act
• Ruth Bader Ginsburg
• US democracy

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Article Contents

Introduction, overview of methods, case studies: quasi-experimental vaccine evaluation, conflict of interest, data availability.

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Quasi-experimental methods for pharmacoepidemiology: difference-in-differences and synthetic control methods with case studies for vaccine evaluation

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Lee Kennedy-Shaffer, Quasi-experimental methods for pharmacoepidemiology: difference-in-differences and synthetic control methods with case studies for vaccine evaluation, American Journal of Epidemiology , Volume 193, Issue 7, July 2024, Pages 1050–1058, https://doi.org/10.1093/aje/kwae019

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Difference-in-differences and synthetic control methods have become common study designs for evaluating the effects of changes in policies, including health policies. They also have potential for providing real-world effectiveness and safety evidence in pharmacoepidemiology. To effectively add to the toolkit of the field, however, designs—including both their benefits and drawbacks—must be well understood. Quasi-experimental designs provide an opportunity to estimate the average treatment effect on the treated without requiring the measurement of all possible confounding factors, and to assess population-level effects. This requires, however, other key assumptions, including the parallel trends or stable weighting assumptions, a lack of other concurrent events that could alter time trends, and an absence of contamination between exposed and unexposed units. The targeted estimands are also highly specific to the settings of the study, and combining across units or time periods can be challenging. Case studies are presented for 3 vaccine evaluation studies, showcasing some of these challenges and opportunities in a specific field of pharmacoepidemiology. These methods provide feasible and valuable sources of evidence in various pharmacoepidemiologic settings and can be improved through research to identify and weigh the advantages and disadvantages in those settings.

This article is part of a Special Collection on Pharmacoepidemiology.

Determining the safety and efficacy of drugs and biologics is crucial, yet it faces many statistical, epidemiologic, regulatory, and logistical challenges. A related yet distinct challenge—determining the effects of health and social policies—has incorporated quasi-experimental study designs into its set of methods. Quasi-experimental methods can provide a convenient means for assessing the real-world effectiveness and safety of pharmacological products—especially those with population-level effects—in well-defined populations and specific circumstances that mitigate the risks of bias.

Quasi-experiments (in some cases also known as “natural experiments”) here refer to observational studies that identify a causal effect by taking advantage of circumstances that create variation in exposure status in ways that avoid the usual sources of confounding for that exposure and the outcome of interest. 1 , 2 This often comes through changes in the exposure that are not otherwise causally connected to the outcome, often referred to as exogeneity. 2 , 3

A suite of such approaches developed or formalized in the quantitative social sciences—including instrumental variables, regression discontinuity designs, interrupted time series, difference-in-differences, and synthetic control methods, among others—have become major empirical approaches in those fields 3 , 4 and have become popular in epidemiology as well. 5 For example, during the coronavirus disease 2019 (COVID-19) pandemic, they have been used to assess the effectiveness of universal masking in schools, 6 vaccine lotteries, 7 and other interventions. 8 , 9 Along with this rise in the use of the methods have come articles describing the uses and limitations of these methods in health policy evaluation. 1 , 2 , 10 , - 16

This article focuses on difference-in-differences (DiD) and the synthetic control method (SCM), quasi-experimental designs that are both controlled (ie, include exposed and unexposed units) and longitudinal (ie, exploit a change in exposure status over time to adjust for unmeasured confounders). 11 , 17

Despite their expanding use in health policy research, these methods have not been extensively studied for use in evaluating drugs and biologics. This article provides a brief overview of these methods (including recent developments from the econometrics literature), advice on settings where they are beneficial for pharmacoepidemiology (exemplified through 3 case studies of vaccine effectiveness evaluation), and discussion of the trade-offs and limitations they face. Finally, the article describes future research that can improve their use in pharmacoepidemiology.

DiD and SCM analyses estimate the average treatment effect on the treated (ATT) by constructing the potential outcome for the exposed units in the (counterfactual) absence of the exposure using both cross-unit and within-unit comparisons. Below, I give a brief overview of these methods and their estimators, along with recent extensions. For a more comprehensive treatment, see the relevant econometrics 3 , 4 or public health review literature. 1 , 10 , 14 , 15 , 17

Difference-in-differences

Schematics showing simulated observed and counterfactual data for 4 quasi-experimental methods: A) difference-in-differences (DiD); B) DiD with staggered adoption; C) synthetic control method (SCM); D) augmented SCM. Vertical lines represent the beginning of exposure in exposed units/groups. Black dotted lines (A, B) and gray shaded regions (C, D) represent estimated effects. Note that different counterfactuals are possible with additional assumptions (B) and that augmented SCM is shown here when the exposed unit lies outside of the convex hull of the unexposed units (D).

Extensions of the DiD model

Several extensions to the DiD model aim to improve the validity of the parallel trends assumption. For example, covariates can be added when parallel trends holds only conditionally, or the so-called difference-in-difference-in-differences (or triple-differences) model can be used to remove nonparallel trends. 4 Both of these have analogous approaches in the epidemiology literature: adjusting for measured covariates in cohort studies for the former, and using negative controls to adjust for residual bias for the latter. 22 , 23

The functional form of the parallel trends assumption can also be changed by transforming the outcome variable. For example, if the counterfactual outcomes are judged more likely to have equivalent multiplicative trends than linear trends, a logarithmic transformation can be used on the outcome. Importantly, only one functional form can truly have parallel trends, so the modeling and estimand choices determine the validity of the causal assumptions made. 24

Recently, literature has extensively investigated DiD in cases where there are units with different exposure-onset times (eg, “staggered treatment adoption”; see Figure 1B ). 25 The TWFE model is subject to biased estimation of the ATT under this setting as the unit and time fixed effects do not properly capture treatment effect heterogeneity. 21 , 25 Various approaches have been proposed to ameliorate this problem in the DiD and related stepped-wedge trials literature 26 , - 30 ; these include different estimators and explicit weighting of time- and unit-specific estimators. 3 , 26 , 27

Synthetic control method

The major assumption of SCM is that these weights are stable, in the sense that a weighting scheme that matches the preexposure outcome trends well will also give an unbiased estimate of the potential outcome after the exposure time point. 31 A long preexposure time series on which to optimize the weights provides the best justification for this assumption under many data-generating processes. 31 For multiple exposed units and/or multiple postexposure periods, the individual estimators can be combined to target the desired estimand. 29 , 33

Extensions of the synthetic control method

One reason for the growth of SCM in comparative case studies is its interpretability: All unexposed units have a nonnegative weight showing their contribution to the estimated counterfactual, allowing discussion of the reasonableness of the counterfactual. However, this also imposes restrictions on the model; SCM does not work when the outcomes of the exposed unit fall outside the convex hull (loosely, the range) of the unexposed units’ outcomes. 31 Thinking of past outcomes as the “adjustment variables,” this requirement is roughly analogous to positivity requirements in cohort studies: Adjustment fails if there are combinations of covariates for which there are only exposed units.

Several extensions of SCM—including the generalized SCM, 34 augmented SCM (see Figure 1D ), 35 and Bayesian structural time series model 36 —trade off some interpretability by allowing outcome modeling and extrapolation outside of the convex hull. This allows the use of more control series, including those on different scales than the outcome itself. 37 This extrapolation, however, can lead to bias, especially when there are few pretreatment periods or unexposed units. 34

Quantifying uncertainty and negative controls

Pharmacoepidemiologic studies require not just point estimates but also quantification of uncertainty, often through P values, confidence intervals, or Bayesian alternatives. 38 For quasi-experiments, this can be more challenging, as they often involve only 1 or a limited number of exposed observations, and rarely form a sample of an identifiable study population. Because of this, model-based estimates of variability—even in cases when they can be computed, such as regression-based DiD and generalized SCM—may not have the desired interpretation or may require additional design-based assumptions. 27

Beyond statistical inference, it is desirable to quantify the causal or model-based uncertainty. Negative controls, sensitivity analyses, and robustness checks provide a means to assess the required assumptions to some extent. These include assessing the validity of the assumptions for the particular setting through models and graphical inspection of preexposure time trends, as well as assessing the model performance in settings with known effects. 17

Repeated negative controls—often called placebo tests or dummy analyses—conducted for different time points (where no change in exposure occurs), different units (ie, only using untreated units), or different outcomes (where the exposure should have no effect) generate null distributions using cases that should identify effects of zero. 3 , 31 Comparing the observed estimate with these distributions allows hypothesis testing. Bayesian frameworks are also feasible but may be sensitive to the prior distributions used. 36 Properly reporting and interpreting these measures of uncertainty remains a challenge for these quasi-experimental methods, especially as they are applied to new fields.

Case studies of the use of DiD and SCM in vaccine evaluation can illuminate the benefits and challenges of these designs. Vaccine evaluation studies demonstrate the use of large-scale routinely collected datasets in the context of exogenous variation to identify key public health effects as a supplement to randomized trial evidence or when it is not available. They also show potential pitfalls: the risk of concurrent events and misspecification leading to bias and the limited generalizability of targeted estimands.

Case 1: SCM analysis of meningococcal vaccines

Prunas et al analyzed the impact of early childhood meningococcal vaccination programs in Brazil and England in the 2010s (see Table 1 ). 39 Real-world estimates of vaccine effectiveness for hard-to-predict and highly variable diseases like invasive meningococcal disease are challenging, making quasi-experiments particularly useful. Using SCM on the logarithmic scale with Bayesian time-series modeling, the authors compared meningococcal disease incidence after the program roll-out with a synthetic control constructed from time series of other (nontargeted) diseases and the targeted disease in older age groups who were ineligible for vaccination.

Summary of meningococcal vaccine analyses in Prunas et al, a 2022.

Abbreviations: CrI, credible interval; MenB, meningococcal serogroup B; MenC, meningococcal serogroup C; SCM, synthetic control method.

a Prunas et al. 39

To demonstrate the value of the method, the authors conducted placebo tests using other quasi-experimental designs and found that the SCM better captured seasonality and nonlinear time trends; notably it avoids the need to specify a parametric time trend. It thus likely suffers from less bias in the desired analyses, although there could still be extrapolation bias due to the time series modeling. 32 , 36

Within-region controls (here, time series of nontargeted populations and outcomes) are particularly valuable for quasi-experimental evaluation of vaccines and drugs. By avoiding comparisons across geographic areas, they mitigate the risk of bias due to concurrent events or changes. However, they come with a potential increased risk of spillover or contamination, especially in infectious disease settings. 40 For the nontargeted age groups, bias could be caused by indirect protection of the vaccine (ie, a younger child receiving the vaccine is less likely to infect an older child in the household). For the nontargeted diseases, there is perhaps less risk of bias, but it could still occur due to off-target effects of vaccination or changes in health-seeking behavior and diagnosis in the wake of the vaccination policy. The authors used placebo tests and sensitivity analyses that dropped the older age groups as candidate control series, finding robust results that suggest these biases were minimal in this setting. 39

The results demonstrated effectiveness of the vaccination program against the targeted infections. Within each country of analysis, results on different early childhood age groups showed remarkable similarity, indicating that there may be some generalizability of these effects. However, as ATT estimands, these may still not be appropriate to transport to other countries with different infection risks. On the other hand, these estimates assess the overall effect of the program, rather than the individual-level direct effect, and so can provide an additional piece of evidence that is rarely achieved in preauthorization trials. 41 This is useful for public health policy-makers as real-world evidence of both the vaccine itself and the vaccination program. 42

Case 2: DiD analysis of an off-target vaccine against COVID-19

Early in the COVID-19 pandemic, researchers sought to use existing drugs and vaccines to prevent infection, illness, and severe outcomes until COVID-19-specific drugs and vaccines could be developed and authorized. The bacille Calmette-Guérin (BCG) vaccine against tuberculosis was one such candidate because of its hypothesized off-target effects, 43 which were supported by cross-sectional analyses showing better COVID-19 outcomes in countries with high BCG vaccination coverage. 44 While randomized controlled trials would eventually occur in specific populations, 43 the emergency situation called for interim evidence to confirm or refute this hypothesis. A preprint by Matsuura et al in 2020 reexamined this hypothesis with a DiD analysis using existing country-level data (see Table 2 ). 44

Summary of BCG vaccine off-target effects vs. COVID-19 analysis in Matsuura et al, a 2020.

Abbreviations: BCG, bacille Calmette-Guérin; COVID-19, coronavirus disease 2019; DiD, difference-in-differences; TWFE, 2-way fixed effects.

a Matsuura et al. 44

The authors identified countries that changed BCG vaccination recommendations at some point in the past and determined for various age groups in each country whether they were in a national vaccination cohort or not. They then conducted a TWFE analysis of the relationship between being in a BCG vaccination cohort and the log of confirmed COVID-19 cases for that age group and country, finding no protective effect of the vaccine. 44

In this study, incorporating within-country controls helped mitigate the bias of comparing across countries cross-sectionally. However, the use of age cohorts as the distinguishing feature risks contamination—as individuals of different ages interact and may provide indirect protection—and concurrent events, since many nonpharmaceutical interventions and recommendations in the COVID-19 pandemic were targeted to specific age groups. Identification for this design requires that the difference in log-cases between age cohorts would be constant (parallel multiplicative trends) across countries absent differential BCG vaccination policies. This would be threatened by differential age-targeted policies.

As in the previous study, the generalizability of the ATT is limited, since it is specific to the age cohorts and countries studied, as well as the time since BCG vaccination inherent in those age groups. However, the staggered adoption that occurs in this setting (different countries changed vaccination rules for different age cohorts) risks a larger problem of bias or incorrect interpretation of the ATT. The estimate given by the TWFE model is a weighted average of individual effects in each country-age cohort combination, with some given potentially negative weights. 21 Careful specification of the estimand and the analysis method in quasi-experimental analyses, especially with staggered adoption, is thus crucial. In this case, individual 2-by-2 DiD analyses may be more useful, providing a range of estimated treatment effects in the different age group-country combinations. 21 , 45

The challenges of estimand interpretation and generalizability limit the internal and external validity of this approach. Nonetheless, it provided useful exploratory evidence that controlling to some extent for country-level factors could account for the correlation observed in a cross-sectional analysis. As this negative finding was borne out by a randomized controlled trial, 43 this study provided immediate useful interim evidence before that trial was concluded.

Case 3: DiD and SCM analyses of the indirect protection of a COVID-19 vaccine

After the authorization of COVID-19 vaccines to prevent symptomatic and severe illness in adults, questions remained about the effectiveness of the vaccines in providing indirect protection by preventing infection and transmission. 41 Winner et al 46 sought to assess the indirect protection of children via adult vaccination by comparing infection rates among Austrian children in the district of Schwaz—which had high adult vaccination uptake due to a campaign during a localized outbreak—to other districts with much lower rates as of March 2021. They used both SCM analysis with other Austrian districts as controls and DiD analyses comparing Schwaz municipalities to neighboring municipalities outside the district (see Table 3 ). 46 All analyses reported strong indirect protection of children. 46

Summary of COVID-19 vaccine indirect protection analyses in Winner et al, a 2022.

Abbreviations: CI, confidence interval; COVID-19, coronavirus disease 2019; DiD, difference-in-differences; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SCM, synthetic control method; TWFE, 2-way fixed effects.

a Winner et al. 46

With a clear time point for the mass vaccination campaign, quasi-experimental methods are a natural design for this setting, and the neighboring municipalities and other districts in the country form a large pool of potential controls. Selecting unexposed units within the same country increases the plausibility of similar nonpharmaceutical interventions and other policies, supporting the assumptions of stable weights and parallel trends. The risk of cross-border contamination through indirect protection remains but would, if anything, yield conservative estimates. Negative controls included an in-space placebo test for SCM (ie, using the same method on nontargeted districts to create a null distribution) and assessment of preexposure parallel trends for DiD. 46

While policies spurred by a particular need create variation, there is risk in using them as quasi-experiments. In this case, a large outbreak in Schwaz spurred the vaccination campaign. This creates concurrent events and anticipation: The past outbreak and the vaccination both influence infection dynamics going forward and may violate the assumptions needed for these methods. 8 The authors sought to use districts with similar prior infection trends to mitigate this bias. Parallel trends could also be threatened by the use of linear functional forms for a nonlinear outcome like infections, although the authors used both a linear TWFE model and a logarithmic 2-by-2 DiD model here. 8 , 17 , 47

Once again, the results are highly contingent on the campaign and the setting in which it was enacted. The differential outcomes result from both the vaccination itself and any changes in behavior that may have resulted from a mass vaccination campaign; this point is well-described in the quasi-experimental literature for policy evaluation. 1 , 19 For pharmacoepidemiologic purposes, then, this makes it difficult to ascribe the full effect to the pharmaceutical itself in such cases. In addition, indirect protection in infectious disease outbreaks is specific to the prior evolution of the outbreak and the population at risk, limiting the generalizability and interpretability of estimates. 23 , 40 , 48 , 49 Nonetheless, the finding of a large indirect effect could inform public health practice and motivate the study of this effect in other settings, even if precise estimates are not transportable. 41 , 42

Quasi-experimental methods provide a promising set of designs for pharmacoepidemiology. The designs discussed here, among others, provide a class of observational study designs that can target useful public health-relevant estimands and provide meaningful real-world evidence in advance of or as a supplement to randomized controlled trials. 14 , 50 , 51 In the case of vaccines, for example, these designs can identify potential off-target effects of pharmaceutical products, encouraging further research into those effects, 44 , 51 and identify rare safety signals through the use of large, routinely collected datasets. 52 In addition, these studies can provide important postmarketing evaluation of the effects of products on their target outcomes in actual use, including indirect effects and changing effectiveness over time as conditions change. 53 , 54

By avoiding the need to measure and model all confounders between exposure and outcome, quasi-experimental methods can achieve high internal validity with routine data sources. 3 , 4 , 32 , 52 This, however, requires other counterfactual assumptions, such as parallel trends or stable weights. Justifying these assumptions, especially the appropriate functional form, requires an understanding of the setting and likely effect. 8 , 17 , 24 As seen in the case studies, both linear and logarithmic scales are used in vaccine evaluation studies, leading to different assumptions and different estimands.

Moreover, spillover and contamination of control units by the exposure and anticipation or lagged effects of the intervention can cause bias, often towards the null. 8 , 27 , 32 For pharmacoepidemiology, this could occur through off-label prescribing or, as in the vaccine cases, indirect effects within networks and communities. Attributing the observed causal effect to the exposure also requires a lack of concurrent events in the study units, which may be threatened by changes in behavior that co-occur with pharmaceutical interventions, like behavior changes that follow vaccination. 5 , 8 , 9 , 17

As in all medical studies, understanding the estimand targeted by these methods is crucial to properly using the evidence. 55 When aggregate population data are used, these methods target aggregate or population-level effects, and thus cannot be transported to individuals. 19 But this also provides useful real-world evidence, such as the overall effect measure in vaccine studies, as seen in the case studies. 23 This is rarely targeted by randomized trials and provides useful additional regulatory and public health evidence. 41 , 42 , 53

ATT estimands from quasi-experimental studies, however, are specific to the setting, exposure, outcomes, and exposed unit(s), as well as the contrast identified and other statistical analysis choices. Since the exposed units are rarely randomly selected (ie, the mass vaccination campaign in Schwaz occurred because of a prior outbreak 46 ), the ATT differs from the average treatment effect that is usually targeted by randomized trials and used in regulatory decisions. 56 It may be of specific interest in safety studies, as it represents the effect of removing the exposure from all exposed units (eg, compare Cowger et al 6 ). In general, however, it may be less transportable to populations yet to be exposed or require further assumptions. 5 , 16

Compared with other observational study designs, quasi-experimental designs tend to trade away some external validity for internal validity, although these aspects should ideally be considered in concert. 3 , 57 Researchers need to be careful about generalizing results of these methods to other settings and populations, especially for outcomes that have marked spatiotemporal patterns (eg, infectious diseases) or for populations with specific health needs and vulnerabilities (eg, specific age groups or people with co-morbidities). 19

Achieving the potential benefits of these designs will require further research and careful reporting and interpretation. The general methodology of these designs in the field of pharmacoepidemiology—as well as how to report results and place evidence in the context of other studies routinely conducted in the field—will be important for ensuring validity and appropriate interpretation. 9 , 11 Connecting the literature across various disciplines will improve uptake of the most appropriate methods as well. Moreover, research on the most appropriate designs for specific settings, considering the populations, interventions, and outcomes, is crucial. 50 This can include simulation studies in those settings to observe the relationship between estimates and true estimands. 15

For example, quasi-experimental vaccine evaluation studies will need to determine appropriate lag times, functional forms, and time frames for the necessary DiD and SCM assumptions to hold. 14 , 52 This can build on the existing health policy and stepped-wedge trials literature. 8 , 47 , 48 Understanding and communicating the trade-offs of identifying population-level effects but potentially losing generalizability will be key to appropriately contextualizing this evidence.

Negative controls, placebo tests, and sensitivity analyses also have an important role to play. Assessing methods for sensitivity to the selection of control units and time periods can inform both internal and external validity. Quantitative placebo tests can also allow the reporting of causal uncertainty alongside statistical uncertainty. 3 Investigators can improve generalizability by using multiple populations (as in the meningococcal vaccine case study 39 ), different methodological approaches or models (as in the COVID-19 vaccine case study 46 ), or multiple units and exposure points (as in the BCG vaccine case study 44 ). The latter, however, targets an estimand that averages potentially heterogeneous treatment effects, which may or may not have greater generalizability—depending on the setting—and can be statistically inefficient. 21 , 30 , 48 The proposed alternatives vary in their targeted estimands, required assumptions, and statistical properties. 25 , - 27 , 45 , 58 Investigation of the assumptions and relative performance of these methods in specific pharmacoepidemiologic settings (see, eg, multiple references 8 , 9 , 17 , 47 ), alongside the appropriate reporting of these challenges, is needed.

Quasi-experimental methods can alleviate some of the challenges of pharmacoepidemiology, while introducing others. Understanding and using them provides another tool for regulators, physicians, and public health policy-makers to understand the benefits and risks of drugs and biologics.

None declared.

The author declares no conflicts of interest.

The views expressed in this article are those of the author alone.

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Microsoft: A Case Study in Strategy Transformation

If you’re leading your team through big changes, this episode is for you.

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In early 2015, Microsoft’s senior leaders were facing a set of difficult decisions. The firm had been struggling to innovate and grow as fast as its competitors. Now they were considering new opportunities that would yield higher growth but lower margins — like shifting away from perpetual licensing to focus on subscription sales.

Harvard Business School professor Fritz Foley studied this period of transformative change at Microsoft for a business case study he wrote. In this episode, he shares how Microsoft’s leaders analyzed different options and worked to get both investors and employees on board with new ideas about growth. He also explains how the company’s risk-averse culture evolved in order to execute such a huge transformation.

Key episode topics include: strategy, growth strategy, business models, corporate governance.  

HBR On Strategy curates the best case studies and conversations with the world’s top business and management experts, to help you unlock new ways of doing business. New episodes every week.

• Listen to the original Cold Call episode: The Transformation of Microsoft (2018)
• Find more episodes of Cold Call
• Discover 100 years of Harvard Business Review articles, case studies, podcasts, and more at HBR.org

HANNAH BATES: Welcome to HBR On Strategy , case studies and conversations with the world’s top business and management experts, hand selected to help you unlock new ways of doing business.

In early 2015, Microsoft’s senior leadership team was facing a set of difficult decisions. The firm had been struggling to innovate and grow as fast as its competitors. Now, they were considering new opportunities that would yield higher growth, but lower margins like shifting away from perpetual licensing to focus on subscription sales.

Today, we bring you a conversation with Harvard Business School professor Fritz Foley, who studied this period of transformative change at Microsoft for a business case study he wrote. In this episode, you’ll get a window into how Microsoft’s leaders analyzed different options and got both investors and employees on board with a different idea of growth. You’ll also learn how the company’s risk-averse culture had to evolve in order to execute such a huge transformation.

This episode originally aired on Cold Call in July 2018. Here it is.

BRIAN KENNY: Electronics enthusiasts in the 1970s looked forward to it every year: the January issue of Popular Electronics . That is because that issue was known for featuring the coolest up-and-coming products in the world of electronics. And when the January 1975 issue hit newsstands, it did not disappoint. The cover was adorned with the first available image of the Altair 8,800, the world’s first mini-computer kit. It may not have been the shot heard around the world, but many say that it was the spark that ignited the home computer revolution. That very magazine inspired a young Paul Allen and Bill Gates to turn their passion for computers into a business that subsequently became an empire.

Today, Microsoft Corporation is the third most valuable company in the world and the world’s largest software company. But after four decades of buffeting the headwinds of the very industry it helped to create, Microsoft is at a turning point and the way forward is not entirely clear. Today we’ll hear from Professor Fritz Foley about his case entitled “The Transformation of Microsoft.” I’m your host, Brian Kenny, and you’re listening to Cold Call .

SPEAKER 1: So, we’re all sitting there in the classroom.

SPEAKER 2: Professor walks in.

SPEAKER 3: And they look up and you know it’s coming. The dreaded cold call.

BRIAN KENNY: Professor Fritz Foley’s Research focuses on corporate finance. He’s an expert on investment capital structure, working capital management, and a range of related topics, all of which probably factor into the case today. Fritz, thanks for joining us.

FRITZ FOLEY: Thanks so much for having me.

BRIAN KENNY: So, everybody pretty much knows who Microsoft is, and I think people will be really interested in getting a glimpse into where they were at this turning point in the company’s history. Still a very, very important company in the landscape of the technology industry and beyond. So, I think people will relate right away to this, but let me ask you, if you could start just by setting the stage for us. How does the case begin? Who’s the protagonist and what’s on her mind?

FRITZ FOLEY: Yeah, so the protagonist is Amy Hood, who is Microsoft’s CFO. She also was a student here at HBS at the time that I was in the PhD program. So, I’ve known her for some time and she’s facing a set of choices that really revolve around whether or not Microsoft should try to pursue increased margin or increased growth.

BRIAN KENNY: Okay. What prompted you to write the case? Your connection with Amy obviously is part of that, but why Microsoft and why now?

FRITZ FOLEY: I think I have been struck by the transformation that they are in the midst of. This is a company that… I mean, it’s hard to remember this. In the early two thousands, the stock price was stuck in the 20 to $30 a share range. And there was a group of people who were calling for the firm to be managed essentially for cash distributions and for increased margins. And then there were some growth opportunities that the company faced simultaneously. So, there was a real choice as to what direction to head. And I think this is a compelling choice that many other companies face. So, it’s a powerful example for me to highlight in course I teach about chief financial officers.

BRIAN KENNY: Microsoft was the first player on this stage really, but then Apple came along and I think many people look at these two as fierce competitors. But can you just talk about the difference between these two companies in terms of how they manage their financial strategy?

FRITZ FOLEY: Yeah, I can say a bit about that. So, at one level, they certainly are similar. They’re in tech space and in fact, many things that Microsoft was attracted to phones in particular, is something that Apple has excelled at. And I think that at the time of the case, they were quite different in the eyes of investors, I would say. I would say that investors still viewed Apple as having a lot of a growth emphasis of a commitment to innovating new products and solving problems that people weren’t even sure they had. Whereas Microsoft was the older, more established tech firm that I think, in the eyes of some, had become not a relic of the past, but less relevant when thinking about future innovations. And in some sense, the cases about how Microsoft tried to shed that view and become a relevant growth-oriented entity again.

BRIAN KENNY: And they’d certainly been criticized over the decades for not moving quickly enough to innovate and getting caught up in their own. And you think about IBM maybe as a company that faced similar criticisms getting caught up in just their size and the bureaucracy of the place. What did Microsoft’s business look like in 2012? Because that seemed to be the beginning of the turning point?

FRITZ FOLEY: Yeah. I mean, it was one where there was varying performance across divisions. There was interest by value activist investors given the large cash holdings that the firm had. Obviously, their market share when it came to the office suite of products and windows, those were quite high. And they were obviously very successful in continuing to provide versions of that to a whole variety of users. They had emerging cloud business, but it wasn’t clear that they would win in that space and had really struggled in other spaces.

In search, Bing never got traction relative to Google. In phones, they were really struggling in 2012 right before they tried to make more headway in phones by buying Nokia, which also subsequently didn’t work out as well as they had hoped. So, I think along a series of dimensions, they were really trying to get some traction, trying to get footing in new spaces. And there were a group of investors that actually felt like that wasn’t what they should do. That they should just focus on Office, focus on Windows, enjoy the high margins that came with their on-premises server and tool business offerings. So, they faced some really hard choices.

BRIAN KENNY: And they were also, in terms of just the organization itself up against some issues, what were some of the things they were encountering culturally at the time?

FRITZ FOLEY: Yeah. I mean, it’s a fascinating story from a cultural standpoint. It was an environment where there were high returns to showing that you were the smartest person in the room. Some of the stories that I have heard are a little jarring. I am not sure I would’ve survived in this environment. There were these very long mid-year reviews that took place and were incredibly demanding. It was an environment that was beginning to really emphasize the desire to be efficient, to be right, and in fairness to them, and Microsoft was coming from a culture or their culture came from a place where they were selling a product that couldn’t really fail. People had very high expectations for the performance of everything Microsoft provided them. And unlike today where there’s more room to update things through online updates, a lot of the software, it shipped and it had to be close to perfect when it shipped.

BRIAN KENNY: Actually, I can remember a time when the launch of a new Windows system was similar to the launch of a new iPhone. People were really excited to get the new system, but inevitably there were bugs and those were highly publicized, and so they fell under a lot of criticism. They were really operating under a microscope for a long time.

FRITZ FOLEY: For sure. And we’re keenly aware that time to fail in their products, which is a measure of how long it took for some product or process to break down, had to be very long. Otherwise, they would meet with a lot of customer dissatisfaction.

BRIAN KENNY: Yeah. Okay. So, let’s move into the transformation phase for them. What was the fundamental shift they made in terms of changing or restructuring the organization?

FRITZ FOLEY: In my view, I think that they did a variety of things to adopt more of a growth orientation. And some of this dealt with their metrics. Some of it dealt with very explicit changes to the culture, and I think some of it also dealt with a realization that pursuing growth would enhance value much more than trying to increase margins and have large dividend payouts or larger dividend payouts to shareholders. So this was, I would say in the 2012, 2013 timeframe, we began to see pieces of this. And they also faced significant managerial changes at that time. That’s when Steve Ballmer retired and they needed to pick a new CEO and could have gone a variety of directions there. And by picking Satya Nadella, effectively we’re committing to more of a growth path.

BRIAN KENNY: Can you think of an example of a company that chose the margins path? And I mean, these are both potentially successful choices, but I would guess.

FRITZ FOLEY: For sure. And it’s a very hard trade-off to make. In teaching my MBA students and executive education students I’m always struck, when I ask them, “Would you sacrifice some margin for growth,” how hard that question can be and how many people don’t have much intuition for it. So, other companies did go the margin route.

BRIAN KENNY: Yeah. Is it a situation where the margin choice is one that’s probably more comfortable and the returns are going to come sooner and the growth choice is a little riskier, and for a risk-averse culture probably harder to implement and you’re betting on the future? Is that fundamentally what the choice is?

FRITZ FOLEY: Yeah. I think that’s a really good way of putting it. Many people find it easier to see the benefits that come with cutting costs and looking for efficiencies and worry that what may come with growth could be elusive. And in some regards, I have heard senior finance managers say that they had to earn the permission to go after growth. They have to get the buy-in from a group of investors who feel as if the senior leadership team has credibility in pursuing growth.

BRIAN KENNY: So, here we have Microsoft, an enormous company, 130,000 or so employees, something like that, large by any measure about to pursue an option that is in many ways counter to the culture of the organization. How do you do that? How do you cascade this kind of a change through an organization of that size?

FRITZ FOLEY: On the cultural side, one thing that they did was very explicitly dropped a growth mindset culture. And Satya Nadella writes about this in his recent book, Refresh. The story is, for me, very compelling. It’s incredibly hard to get any organization to change its culture. Whenever I’ve been a part of an organization that tried to engage in a cultural shift, whatever the tagline was, quickly became the punchline for a set of office jokes.

BRIAN KENNY: I’ve been on the other side of that. I’m the guy who writes the punchlines most often.

FRITZ FOLEY: Yeah. So, you know how hard this is. And I think that they were very wise in picking Kathleen Hogan who had led one of the divisions of Microsoft to head up the charge to describe and roll out this cultural change. They brought senior leaders on board, and ultimately, I think there was a lot of demand for it that many people who were working at Microsoft were innovative engineers and a very creative set of employees who wanted to pursue growth. And when given the choice to move away from review processes and given the opportunity to go to meetings where they didn’t feel like they had to be exactly right in making a point, but could stimulate the beginning of a discussion set of ideas that could lead to something that was new, people embraced that.

BRIAN KENNY: And here we are in the age of the millennial worker. Millennials don’t want to work for the old Microsoft for sure. And Microsoft is competing with the likes of Google and Apple and other firms that are definitely perceived as open and innovative, and they want people with energy and ideas. So, they have to adopt that same personality, I guess.

FRITZ FOLEY: Yeah, I agree with that. I think there’s a new buzz about Microsoft, at least among my students, they’re much more intrigued by what it would mean to work there and what opportunities exist to do some things that would be truly novel and have a big impact on how people get work done.

BRIAN KENNY: So, let’s go back to our protagonists. Amy Hood in the case actually delves into her mindset a little bit. She’s getting ready to communicate these changes to the financial community. What are the kinds of things a CFO would have to think about? Because I can imagine the financial probably is more comfortable with the margin choice than the growth choice

FRITZ FOLEY: Yeah, for sure. It’s fun for me to imagine her faced with this choice really of, okay, I can go this path of growth, but if I do this, I am going to have to go to my investors and say, our margins are going to go down for some period of time, and you’re not going to like that. But there’s going to be some upside and it will take some time for that upside to show up. So, I think she needed to find ways to communicate or signal what that upside would be and how big it might be to the investors so that she wouldn’t lose credibility with them and would have the permission essentially to pursue growth.

BRIAN KENNY: Yeah. Now we hear it all the time about the emphasis on the short-term, short-termism in the financial community, and people want returns and they want them right away. In your experience, are you seeing a shift in the financial community, or are the analysts getting a little more comfortable with this notion of you can’t always go for the margins, you’ve got to find some sustainable growth in the long term?

FRITZ FOLEY: Yeah. It’s a great question. It’s one that troubles me or is something I think about our financial system generally. I happen to be probably more optimistic relative to many when it comes to how short-term-oriented, or really how financial markets aren’t as, as some might worry, or that concern about short-termism doesn’t resonate as much with me. I do think there is a big burden on senior finance teams to explain how value is created by thinking long-term and embracing growth opportunities. And in some sense, when I look at what Amy has been doing at Microsoft, I applaud her and her team for taking on that challenge. They quite explicitly set a target of a $20 billion run rate for their commercial cloud business, and once analysts had that number, they could begin to build off of it and get a feel for how much value could be created if Microsoft succeeded at pulling this off.

So, by having the courage to commit to that path and help analysts understand what the path meant, I think that they have been effective in pursuing it. More generally, I do worry that there are some analysts that simply take an earnings-per-share number and apply some current multiple and don’t think much about what the future will look like. I am hopeful that finance teams and organizations will play a role in educating analysts as to how they should think about the future, when growth opportunities do exist and are attractive.

BRIAN KENNY: Yeah. You mentioned earlier that you’ve talked about this in class, and I’m just curious, do the MBA students come at this differently than the executive education students who have been in fiduciary roles and organizations already?

FRITZ FOLEY: Yeah. That’s an interesting question. Let me reflect on that for a moment. I think the approach is fairly similar. I would say that some MBA students are probably less aware of the constraints that capital markets may put on senior management teams to pursue growth. They’re less aware of what an activist who wants cash now might push management to do, whereas executive education students tend to be keenly aware of those pressures. If anything, I find that MBA students, it’s a little bit harder for them to articulate what is the case for pursuing margin for Microsoft in 2012, 2013. Many executive education students are quick to come up with lists of things that could be done strategically financially in picking leadership.

BRIAN KENNY: Yeah, it’s interesting. And anybody who’s worked in an organization for any period of time, going back to that whole notion of how hard it is to change a culture, it’s pretty easy to think of reasons why not to pursue that path. So, I thought maybe some of the exec ed students might come at with those constraints already wrapped around themselves.

FRITZ FOLEY: Yeah, I agree.

BRIAN KENNY: Yeah. Fritz, thanks for joining us today.

FRITZ FOLEY: Thanks very much for having me.

HANNAH BATES: That was Harvard Business School Professor Fritz Foley in conversation with Brian Kenny on Cold Call . We’ll be back next Wednesday with another handpicked conversation about business strategy from Harvard Business Review.

If you found this episode helpful, share it with your friends and colleagues and follow our show on Apple Podcasts, Spotify, or wherever you get your podcasts. While you’re there, be sure to leave us a review. And when you’re ready for more podcasts, articles, case studies, books, and videos with the world’s top business and management experts, find it all at HBR.org.

This episode was produced by Ann Saini and me, Hannah Bates. Ian Fox is our editor. Special thanks to Maureen Hoch, Adi Ignatius, Erica Truxler, Ramsey Khabbaz, Nicole Smith, Anne Bartholomew, and you, our listener. See you next week.

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We initiate a systematic study of non-planar on-shell diagrams in N = 4 SYM and develop powerful technology for doing so. We introduce canonical variables generalizing face variables, which make the d log form of the on-shell form explicit. We make significant progress towards a general classification of arbitrary on-shell diagrams by means of two classes of combinatorial objects: generalized matching and matroid polytopes. We propose a boundary measurement that connects general on-shell diagrams to the Grassmannian. Our proposal exhibits two important and non-trivial properties: positivity in the planar case and it matches the combinatorial description of the diagrams in terms of generalized matroid polytopes. Interestingly, non-planar diagrams exhibit novel phenomena, such as the emergence of constraints on Plücker coordinates beyond Plücker relations when deleting edges, which are neatly captured by the generalized matching and matroid polytopes. This behavior is tied to the existence of a new type of poles in the on-shell form at which combinations of Plücker coordinates vanish. Finally, we introduce a prescription, applicable beyond the MHV case, for writing the on-shell form as a function of minors directly from the graph.

This article was originally published in Journal of High Energy Physics, available at http://dx.doi.org/10.1007/JHEP06(2015)199

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Correction to: Boys’ Love (BL) Literacy Products Consumption as Leisure and its Impact on perceptions of LGBTQ + People: a Case Study of the Chinese BL Fan Community in North America

• Published: 12 July 2024

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• Yating Liang   ORCID: orcid.org/0000-0002-7782-6420 1 &
• Haiyan Li   ORCID: orcid.org/0000-0002-1437-4383 2  

The Original Article was published on 28 May 2024

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Correction to: International Journal of the Sociology of Leisure

https://doi.org/10.1007/s41978-024-00156-2

The original version of this article unfortunately published online with error in the abstract section.

In the abstract section, the first sentence currently reads: “This case study investigate show”. A correction should be made as the following: “This case study investigates how Chinese Boys’ Love (BL) fans in North America construct fandom based on their consumption of BL literacy products and whether such consumption can enhance acceptance and support of the LGBTQ + community.”

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Yating Liang

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Liang, Y., Li, H. Correction to: Boys’ Love (BL) Literacy Products Consumption as Leisure and its Impact on perceptions of LGBTQ + People: a Case Study of the Chinese BL Fan Community in North America. Int J Sociol Leis (2024). https://doi.org/10.1007/s41978-024-00163-3

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More From Forbes

How BCG Is Revolutionizing Consulting With AI: A Case Study

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In a world where AI is transforming every sector, companies are constantly seeking ways to gain a competitive edge. Boston Consulting Group (BCG) is leading the charge by embracing artificial intelligence (AI), particularly generative AI, to revolutionize its internal operations and consulting services. Let’s delve into how BCG is leveraging AI to transform its business processes and the consulting industry as a whole.

The Strategic Importance Of AI At BCG

AI is not just a buzzword at BCG; it is a fundamental element of their strategy. Vlad Lukic, Managing Director and Senior Partner at BCG, emphasizes the significance of AI, stating, "It gets into the crux of our business, right? And it's going to be fundamental to the toolkit and skills that we need to have." AI serves as an assistant, enabling BCG consultants to operate at unprecedented speeds, thus allowing them to generate insights faster and drive impactful results for their clients.

Real-World Applications Of AI At BCG

1. Interview Processing and Analysis:

Lukic recalls his summer internship, where he had to interview 30 engineers about materials science over three days, transcribe the conversations, distill the insights, and create slides. This labor-intensive process took two weeks. In contrast, a recent consultant used BCG's enterprise GPT to perform a similar task. "On the third day, he had slides and insights ready to go," Lukic marvels. The AI tool transcribed interviews, highlighted key themes, and generated draft presentations in minutes, reducing a two-week process to two or three days.

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2. Gene: BCG's Innovative Conversational AI:

Another striking example of AI's impact at BCG is the development of Gene, a conversational AI designed to engage with humans and create audio experiences. Originally conceived as a co-host for BCG's "Imagine This" podcast about the future, Gene has evolved into a versatile tool for client engagement and content creation.

Paul Michelman, editor-in-chief at BCG, explains, "Gene was born for a specific job, really one job, and its original training was to be a co-host of a podcast." However, the potential of Gene quickly became apparent, and its applications have expanded. Gene now appears at live events with clients and other audiences, engaging in conversations about the future of AI and thought leadership.

Enterprise GPT: A Game Changer

BCG's enterprise GPT is a cornerstone of their AI strategy. Rolled out to every employee, this tool ensures all data remains within BCG's control. Consultants can also build their own GPTs for specific engagements, fostering innovation and efficiency. Over 3,000 GPTs have been created, addressing tasks from document summarization to administrative functions. Lukic highlights its impact on productivity, noting, "It's really helping us move to a different level of speed."

Evolving Roles And Skills In The AI Era

With AI taking over routine tasks, the role of consultants is evolving. Lukic underscores the need for purposeful toil and sanity checks to ensure junior consultants develop essential skills. He explains, "We are forcing some of those conversations with our team members, so that we can build their skills along the way." This includes teaching consultants how to engage with AI tools effectively, ensuring they can provide accurate and reliable insights.

The development of Gene has also prompted new considerations in AI deployment. Bill Moore from BCG Design Studios, who created Gene, explains the challenges in balancing autonomy and control: "We adjust, we work with the temperature to keep that sort of fine-tuned and we'll drop it down to zero if we need really accurate responses."

Measuring The Impact Of AI

BCG conducted a scientific experiment involving 750 employees to measure the impact of generative AI on performance and efficiency. The results were compelling. For straightforward tasks, productivity increased by 30-40% for new hires and 20-30% for experienced consultants. However, for complex tasks, productivity sometimes decreased due to the challenges of debugging AI-generated outputs. This experiment highlighted the importance of understanding where AI can be most effective and implementing proper guardrails to ensure accuracy.

Insights From BCG's GenAI Experiment

BCG's broader research into generative AI reveals significant insights into its value and potential pitfalls. The study found that around 90% of participants improved their performance when using GenAI for creative ideation. However, when applied to business problem-solving—a task outside the tool's current competence—many participants trusted misleading outputs, resulting in a 23% decline in performance compared to those who didn't use the tool. This underscores the necessity of proper training and understanding the limitations of AI tools.

Ensuring Accuracy And Mitigating Risks

To mitigate risks associated with AI, BCG has implemented several guardrails. Human experts review AI-generated insights, and workflows are designed to ensure continuous oversight. Additionally, BCG fine-tunes their models based on usage and feedback, reducing the likelihood of errors.

In the case of Gene, transparency and ethical considerations are paramount. Paul Michelman emphasizes, "We think it's very important... to be fully clear when we're using technology. And two, to really avoid anthropomorphizing." This approach extends to Gene's voice, which is intentionally androgynous and slightly robotic to clearly differentiate it from a human.

Governance And Strategic Implementation Of AI

BCG employs a dual approach to AI implementation. While top-down initiatives identify key workflows that can benefit from AI, grassroots innovation is also encouraged. A senior task force focuses on internal support functions and consulting cohorts, identifying where AI can eliminate bottlenecks and enhance productivity.

The Future Of Consulting In The AI Era

Looking ahead, AI is poised to reshape the consulting industry. Lukic predicts that within a decade, 50% of current tasks will be automated through AI, allowing consultants to focus more on change management and driving adoption within client organizations.

Bill Moore envisions a future where conversational interfaces like Gene become a new layer of interaction with technology, potentially revolutionizing accessibility and user experience.

Strategies For Successful AI Adoption

For CEOs considering AI adoption, Lukic offers two key pieces of advice. First, don't wait. Start addressing frictions and building the necessary governance structures now. Second, engage the organization. Avoid outsourcing AI implementation entirely and instead, focus on building internal capabilities.

Transforming Consulting With AI

BCG's strategic application of AI, particularly generative AI and conversational AI like Gene, showcases how embracing technology can revolutionize internal processes and enhance client service. By leveraging AI tools like enterprise GPT and Gene, BCG is boosting productivity, fostering innovation, and preparing its workforce for the future. As AI continues to evolve, BCG's proactive approach provides a valuable blueprint for other organizations aiming to harness the power of AI in their own operations.

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Top Picks Of 2023: The Profs Who Wrote The Most-Read Case Studies

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Authors of the top-selling cases of 2023. Courtesy the Case Centre

The Case Centre has revealed the Top 50 Best-Selling Case Authors for 2022-2023, featuring a blend of new and familiar names.

Case studies, which use real-life problems faced by business executives, are still among the most widely used education tools for MBA students across the globe, and the Case Centre, a London-based nonprofit, distributes the largest collection of management case studies to business schools globally. There’s a good chance that many of the case titles on this year’s list of the top-selling cases will be familiar to those in higher ed.

VETERAN AUTHORS IN THE SPOTLIGHT

Though he died in May 2021, Debapratim Pukayastha of ICFAI Business School in India is still holding onto the No. 1 place for the eighth year in a row. Among Pukayastha’s best-selling cases are the case of a safety lapse at a BP oil refinery in Texas City that led to one of the work workplace accidents historically; a case looking at how Netflix leverages Big Data to predict their hits, and a case examining how Procter & Gamble develops new products.

“…I have also found that regularly writing cases can greatly improve classroom teaching. So, I feel that case teaching and case writing should follow each other as the left foot follows the right. Case writing can be a lonely activity and even hard work, but if you have the passion it’s worth it! There are few joys that can compare to the joy of teaching your own case. And it means you can also have a positive impact in classrooms around the world where your case is taught,” said Pukayastha.

Indu Perepu – Assistant Professor at ICFAI Business School (IBS). Courtesy Case Centre

Fellow ICFAI Business School faculty member Indu Perepu has held strong at No. 2 for three years in a row, and is the highest ranked female author on the list. Her most popular cases include Airbnb: A Disruptive Innovator, a case discussing Snapchat’s growth and controversies, and a case involving Yahoo! acquiring Rockmelt.

“Writing a case study is enriching as well as challenging. For me, every case has been a great learning experience, that is enriched further when we see it being discussed in the classroom. Engaging discussion sessions, students’ active participation and debates, along with analyses driven by a case study, offers a sense of fulfillment. The fact that my teaching cases have been discussed by the academic community worldwide is extremely gratifying,” says Perepu on the Case Centre’s site.

EMERGING AUTHORS IN THE SPOTLIGHT

Female representation held steady on the list of top-selling cases this year, with the same percentage of top women authors in the mix as last year: 22%. That’s up from 18% in 2020-2021 and 12.5% in 2019-2020. Despite the steady percentage this year, the trend of increasing female authors is anticipated to rise further as women reach and surpass gender parity in the higher education landscape.

New in the spotlight ranking No. 12 is Arpita Agnihotri , an associate professor of management at Penn State-Harrisburg. She’s taught Strategic Management, Marketing, International Business, Creativity, Innovation, and Organizational Learning. Arpita’s prior role at Egon Zehnder includes recruitment, training, and knowledge management.

“The eagerness and enthusiasm amongst students to put themselves in the shoes of the protagonist and resolve the challenges propels me to write case studies,” says Agnihotri.

Senior Lecturer at Newcastle University Business School Saurabh Bhattacharya is sharing the No. 12 place with Agnihotri in this year’s best selling case authors list. He teaches both undergraduate and postgraduate modules, such as Marketing Research, Research Methods, Digital Marketing, Retail and International Marketing. He also leads Marketing Research and Digital Marketing modules.

“In writing a case, it is essential to emphasize the issue in hand that students are trying to solve or what opportunities they need to capitalize on. Accordingly, I provide apt information in the case, based on which students can decide on the issue or opportunity,” says Bhattacharya.

As co-authors, Agnihotri and Bhattacharya jointly created several bestselling cases covering the topics of Beyond Meat’s valuation justification, Intel’s outsourcing dilemma, and Corona beer’s brand association during the pandemic.

WHERE THE CASES CAME FROM

Leading the way in serving as the academic home to top case writers are well-established schools, with eight authors out of Harvard Business School , six from INSEAD , and five out of the International Institute for Management Development (IMD) .

In addition to the renowned institutions, the 2022-2023 list features six newcomers: ESMT Berlin , HKU Business School , Hult EF Corporate Education, Imperial College Business School , Newcastle University Business School, and Penn State Harrisburg.

Of this year’s list, authors hail from 24 different business schools in 11 separate countries. That includes 34% from the United States, and 22% from Asia.

See the full list of this year’s case-writing winners below, including links to their bios.

1. The Top 50 Bestselling Case Authors 2022/23 – full list

• Debapratim Purkayastha
• Indu Perepu
• Renée Mauborgne
• Wolfgang Ulaga
• Christopher Bartlett
• Syeda Maseeha Qumer
• Kamran Kashani
• Vivek Gupta
• Rajiv Fernando
• Jitesh Nair
• Arpita Agnihotri
• Saurabh Bhattacharya
• Sanjib Dutta
• GV Muralidhara
• Herminia Ibarra
• David B Yoffie
• Garima Ratna
• Youngme Moon
• Kasra Ferdows
• Pierre Chandon
• Jan W Rivkin
• Denis Gromb
• Elizabeth Grasby
• Peter Killing
• Vincent Dessain
• Robert F Bruner
• Michael Lewis
• Jose AD Machuca
• Urs Mueller
• Gianpiero Petriglieri
• V Namratha Prasad
• Frédéric Dalsace
• Benjamin C Esty
• David J Collis
• John A Quelch
• Dominique Turpin
• Jamie Anderson
• Konstantin Korotov
• Stefan Michel
• Stephan Schubert
• James E Hatch
• Marc Kitten
• Ulf Schaefer

DON’T MISS 2023 CASE CENTRE AWARDS: HUGE VARIETY OF TOPICS, BUT THE COVID FACTOR REMAINS and RANKING THE TOP 50 MBA CASES OF THE LAST 50 YEARS

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Value of Information (VOI) Case Study on ETAP

EPA conducted a value of information (VOI) analysis to weigh the public health and economic trade-offs associated with the timeliness, uncertainty, and costs of conducting the EPA Transcriptomics Assessment Product (ETAP) compared to traditional human health assessment processes. Fewer than a quarter of the tens of thousands of chemicals in commerce--as well as those found in the environment, various waste streams, and the human body--have traditional toxicity or epidemiological data that can inform human health risk assessments. ETAP is a novel human health assessment approach aiming to address this challenge by targeting chemicals that lack traditional tox

• Value of Information (VOI) Analysis

Final VOI Report

Voi analysis of etap.

VOI analysis was a recommendation from the  2009 National Academies of Sciences (NAS) report Science and Decisions Advancing Risk Assessment  to provide EPA with an objective decision framework to assess the trade-offs of time, uncertainty, and cost in choosing testing methods for a variety of chemical exposure scenarios and decision contexts.

EPA developed and published a VOI framework . This framework was applied to a case study evaluating the human health and economic trade-offs of the recently released ETAP that relies on a standardized five-day in vivo transcriptomic-based toxicity study compared to a traditional human health assessment using a two-year rodent study. Both the ETAP and a traditional human health assessment results in a reference value representing the daily dose of a chemical substance that would be unlikely to result in an adverse health effect following oral exposure in humans.

The process to conduct an ETAP is shorter and less costly, but with the trade-off of presumed greater uncertainty. Once the chemical of interest is in the lab, an ETAP can be completed in less than a year. Traditional toxicity testing and assessment processes can take several years.  An analysis of the scientific literature and internal studies indicate high concordance between the ETAP-derived values and traditional animal studies across species, sex, route of exposure, physical chemical properties, toxicokinetic half-life, and technology platform.

In the case study, the ETAP and traditional toxicity testing and human health assessment processes are evaluated using a socioeconomic analysis that compares and quantifies the public health (i.e., societal health benefits) and return on investment associated with obtaining information to inform a regulatory decision.

This video provides more details about the VOI.

In the VOI analysis, the ETAP was the preferred testing method in the majority of scenarios considered. The analysis was performed for various combinations of exposure conditions, health endpoints, exposure control costs, population characteristics, and decision types using a range of values informed by real-world data. The VOI results indicate that reducing the time to decision, realized by using the shorter-duration ETAP process, has significant public health and economic benefits when compared with the longer traditional toxicity testing and human health assessment process.

• Final VOI Case Study Report and Supplemental Materials

VOI Materials Prepared for BOSC Review

• VOI Case Study Report for BOSC Review (pdf)   (3.1 MB)
• VOI Case Study Supplemental Material for BOSC Review (pdf)   (1.4 MB)
• Board of Scientific Counselors Panel for VOI

Learn more:

EPA’s  Safer Chemicals Research  aims to address the challenge of needing more chemical information to make informed, risk-based decisions.

• Standard Methods
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