The Journal of Bone and Joint Surgery (American). 2009;91:15-20.
doi:10.2106/JBJS.H.01570
© 2009 The Journal of Bone and Joint Surgery, Inc.
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Principles of Designing an Orthopaedic Case-Control Study

Jason W. Busse, DC, MSc, PhD1 and William T. Obremskey, MD, MPH2

1 Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, ON M5G 2E9, Canada. E-mail address: jbusse{at}iwh.on.ca
2 Division of Orthopedic Trauma, Vanderbilt University, Medical Center East-South Tower, Suite 4200, Nashville, TN 37232-8774

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from the Canadian Institutes of Health Research and Canadian Chiropractic Research Foundation. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Many surgical questions are not amenable to investigation with a randomized controlled trial; thus, investigators must select an appropriate observational study design. Case-control studies are relatively inexpensive and can be conducted in comparatively little time. Although there are important methodological limitations associated with this trial design, case-control studies can provide important insight into the association between one or more exposures and a specific outcome. They are particularly useful when the outcome of interest is rare or when the time to development of the outcome is long. We present an overview of the case-control study, with a focus on trial design and interpretation of results.


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