The Journal of Bone and Joint Surgery (American). 2009;91:21-26.
doi:10.2106/JBJS.H.01573
© 2009 The Journal of Bone and Joint Surgery, Inc.
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How to Design a Good Case Series

Bauke Kooistra, BSc1, Bernadette Dijkman, BSc1, Thomas A. Einhorn, MD2 and Mohit Bhandari, MD, MSc, FRCSC1

1 Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 2X2, Canada. E-mail address for M. Bhandari: bhandam{at}mcmaster.ca
2 Department of Orthopaedic Surgery, Boston Medical Center, 818 Harrison Avenue, Dowling 2 North, Boston, MA 02118

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. 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.

A case series is a descriptive study that follows a group of patients who have a similar diagnosis or who are undergoing the same procedure over a certain period of time. As there is no experimental protocol or control for allocation of patients to treatment, surgeons and patients decide on whether or not treatment is given, making the clinical sample representative of a common clinical population. Results of case series can generate hypotheses that are useful in designing further studies, including randomized controlled trials. However, no causal inferences should be made from case series regarding the efficacy of the investigated treatment. This article will provide principles for the design, analysis, and reporting of case series, illustrated by examples from the orthopaedic surgical literature.


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