Descriptive Study (Case Reports and Case Series)

Descriptive Study (Case Reports and Case Series) A. Case Report A case report is a report on an interesting experience of a person (case) that contains a detailed report or profile of the patient (case). For example, a case report in 2014 about 1 40-year-old woman in Paris who got Ebola. 1. Purpose a. Obtained information on the frequency distribution of the disease or health problem under study b. Information is obtained about groups at high risk of disease c. Can be used to build or formulate new hypotheses 2. Weaknesses a. The distribution, frequency of diseases obtained may not be representative of the population b. Based on reported cases only 3. Pros a. As the first step to study a disease b. As a bridge between clinical research and epidemiologic research c. Can be used as a basis for further research: 1) By looking at high-risk groups 2) By proving the hypothesis that was built 4. Limitations of Case Reports a. No group controls b. Cannot be used for testing c. Relationship may be coincidental, not an epidemiologic design event 5. Example An unclear disease called X disease, 10 people with similar symptoms to each other. a. Based on Symptoms and Laboratories  Weight loss: 9 people with symptoms of weight loss, 1 person with no weight loss.  Diarrhea: 6 diarrheas, 4 no diarrhea  Fever: 8 fevers with pneumonia, 4 no fever  Skin spots: 7 people have, 3 no spots  Laboratorial examination: all patients lymphocyte count decreased dramatically b. Based on Demographic Features  Sex: 9 male, 1 female  Age: 8 young adults, 2 old  Occupation: 6 musicians, 4 employees  Habit of consuming "drugs”: 8 people use needles, 2 people are nonusers.  Sexual behavior: Same sex 8 people, opposite sex 2 people From the data above, it can be seen that: 1. From the symptoms and laboratorial examination of the disease X is:  90% weight loss  60% diarrhea  80% fever with pneumonia  70% skin spots  100% lymphocytes decreased dramatically 2. From the demographic picture:  90% male  80% young adults  60% musicians 3. From the habit of taking drugs:  80% of drug addicts 4. From sexual behavior  80% homosexual From the simple analysis above, information on groups of people at risk is obtained, among others:  Symptoms and signs and laboratorial examination  Demographic features  Drug habits  Sexual behavior From this information, a hypothesis can be built: 1) Men 2) Young adults 3) Musicians 4) Drug addicts 5) Homosexual To obtain information that can describe the distribution, frequency of diseases that represent the population, another descriptive epidemiological study is needed, in which the research sample is representative of the population under study → the appropriate epidemiological study design used for this is a cross-sectional study design. To prove the hypothesis, further analytical epidemiologic studies can be conducted, among others: 1. Cohort study 2. Case-control studies 3. Interventional studies B. Case Series Case Series is an advanced stage of case report that describes several patients with one particular disease based on, for example: age, gender, marital status, clinical features, etc. For example: identification of AIDS cases in homosexual men. Case series report is a report on the interesting experience of a group of people (group) with the same diagnosis that contains a detailed report or profile of the patient (case). It can also be a collection of case reports that occurred within a short period of time. An example is the 1980 case report of 5 previously healthy homosexual youths who developed pneumocystis carinii in LA (USA). Both forms of study are useful in the recognition of new diseases and hypothesis generation. Case Series Epidemiologic Studies are observational epidemiologic studies. The unit of observation or unit of analysis is the individual. It is a collection of individual cases of a disease with the same diagnosis. Similar to case report studies but with more cases. Surveillance that is routinely carried out for a disease with an unclear diagnosis or a clear diagnosis:  A collection of case reports, or case series  Can be used to detect the emergence of new diseases  Can also be used to detect epidemics The collection of case reports is then analyzed in a simple way, namely by seeing:  Disease distribution or frequency  Based on "Person, Place, Time" 1. Objective a. Obtained information on the frequency distribution of the disease or health problem under study b. Information is obtained about groups at high risk of disease c. Can be used to build or formulate new hypotheses 2. Weaknesses a. The distribution, frequency of diseases obtained may not be representative of the population b. Based on reported cases only 3. Advantages a. As a first step to study the epidemiologic picture of a disease b. As a bridge between clinical research and epidemiologic research c. Can be used as a basis for further epidemiologic research:  By looking at groups suspected to be at high risk  By proving the hypothesis that was built