CASE - CONTOL STUDY DESIGN

The case study design involves an intensive exploration of a single unit of study, such as a
person, group, community, or institution. Although the number of subjects tends to be small
number of variables in case study is large. In fact, it is important to examine all variables that
may have an impact on the situation being studied. Well designed case studies are a good source
of descriptive information and can be used as evidence to support or invalidate theories.
Case control studies may use physiologic measure or valid psychosocial measures.
This strategy can greatly expand understanding of a phenomenon under study; case control
studies are useful for demonstrating the effectiveness of a therapeutic technique.

Case control study design ,examine, the possible relation of an exposure to a certain disease ,we
identify a group of individuals with that disease (called case) and for purpose of comparison a
group of people without that disease (called controls)
Case control studies have a potential for revealing important findings that can generate a new
hypothesis for testing. Thus can lead to the design of large sample studies to examine factors
identified by the case study case control studies depends on circumstances of the case but usually
includes an element of time.
Select of cases and control
Selection of case
In case control study cases can be selected from a variety of sources, including hospitals
patients, patients in physicians practices or clinic patients and community registries that keep
information. If hospitals are not open sources of information should be of a wider source to
capture all factors related to the disease
In this study it is preferable that incident cases of the disease be used in the case control study of
disease etiology. The reason is that any risk factors identified in a prevalence case of case study
may be related to survival with the disease than to the development of disease.
Selection of controls
A fundamental conceptual issue relating to selection of controls should be similar to
the areas in all respects other than having a disease in question or whether they
should be representative of all persons without the disease, this has raised
considerable discussion. Control can be selected from non hospitalized and hospitalized

individuals.

Matching
A major concern in conducting case control study is that case and controls may differ in
characteristics or exposure other than the one that has been targeted for study. If more cases than
control are found to have been exposed, we may be left with the question of whether the
observed association could be due to differences between the case and controls. In factors other
than the exposed being studied.
Group matching (frequency matching)
Consist of selecting controls in such a manner that proportion of controls with a certain
characteristics is identical to the proportion of case with the same characteristic. Thus if 25%of
the case are married the controls will be selected so that 25% of that group is also married.
Individual matching
In this approach for each case selected for the study a control who is selected who is similar to
the case in terms of specific variable or variables of concern for example if the first case enrolled
is 45 year old white woman a 45 year old female will be sought for control.
Problems with matching
1) Practical problems with matching if on attempt is made to match according to too many
characteristics it may prove difficult or impossible to identify an appropriate control.
2) Conceptual problems with matching
Problems of recall
A major problem in case control studies is that of recal. Recal problems are of the
two types
1) Limitations in recall
Because virtually all human beings have different abilities in recalling
information limitations of recal are important in such a study. Some individuals
being interviewed may not have information being requested.
2)
Recal bias
A more serious potential problem in case control studies is that carried out on
congenital malformations to prenatal infections, and that of mothers with children
without congenital malformations.
The mother with children with congenital malformation may recall unusual events
in prenatal period that lead to malformation, mothers with children with children
without congenital malformation may not recall information or events that were
unusual during prenatal period.