used case study synonym

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What is another word for case study ?

Synonyms for case study case study, this thesaurus page includes all potential synonyms, words with the same meaning and similar terms for the word case study ., princeton's wordnet.

• case study noun

a careful study of some social unit (as a corporation or division within a corporation) that attempts to determine what factors led to its success or failure

a detailed analysis of a person or group from a social or psychological or medical point of view

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• Corporation

Concise Medical Dictionary, by Joseph C Segen, MD Rate these synonyms: 2.2 / 5 votes

Synonyms: Epidemiology Anecdotal report, anecdote, single case report

How to pronounce case study?

How to say case study in sign language, how to use case study in a sentence.

Houston Astros :

I think I’m kind of a case study on this one.

Sam Goodman :

The Hong Kong BNO scheme is an interesting case study of what can happen if there is political will, there are 12 welcome centers across the country and a really good support package which costs relatively little, including help with English language. And most importantly they just didn’t politicize it. All this has meant that 144,000 Hong Kongers have come here with little to no fuss, integrated quickly and there have been minimal issues.

Tesoro Corp :

We agree on the critical importance of continually learning from incidents and improving the safety of our operations, and inaccuracies in the case study do not detract from our resolve to learn from these incidents.

Alba Pasini :

This case study is really important, since it testifies that a medical approach to maternal morbidity actually existed during the Lombard period, despite the rejection of the scientific progress which denoted all the Early Middle Age, also, it shows two rare findings, since post-mortem fetal extrusion is a quite rare phenomenon( especially in archaeological specimens), while only a few examples of trepanation are known for the European Early Middle Age.

Josh Holmes :

For those asking, this is my response to West Virginia Roy Moore :' This clown is a walking, talking case study for the limitation of a prison's ability to rehabilitate,'.

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What Is Another Way to Say “Use Case”?

January 9, 2024

Linda Brown

Looking for synonyms for use case ? We’ve got you covered!

Here’s a list of other ways to say use case .

• Application
• Illustration
• Practical application
• Usage scenario
• Demonstration
• Usage example
• Application scenario
• Functionality example
• Operational instance
• Implementation example

Want to learn how to say use case professionally? Keep reading for examples and use cases.

1. Application

Use ‘application’ when referring to how a concept or product is used in a practical situation. Example: “The application of this software in data analysis greatly improves efficiency.”

2. Scenario

‘Scenario’ is appropriate for describing a hypothetical or real situation to demonstrate how a system or process would function. Example: “In this scenario, the emergency response system dispatches aid within minutes of receiving an alert.”

Use ‘example’ when providing a specific instance or illustration of how something can be used or occurs. Example: “A good example of this technology’s use is in automated inventory management.”

4. Instance

‘Instance’ is used to describe a particular case or occurrence of something happening or being used. Example: “One notable instance of successful project management was the completion of the bridge ahead of schedule.”

5. Situation

Use ‘situation’ to describe a set of circumstances under which certain applications or systems might be used. Example: “In a situation where data security is critical, our encryption tools become essential.”

6. Case Study

‘Case study’ is appropriate for a detailed analysis of a particular application or use case, often used for educational or demonstration purposes. Example: “The company’s turnaround is a case study in effective leadership and strategic planning.”

7. Illustration

Use ‘illustration’ when providing a visual or descriptive example of how a concept or process is applied. Example: “This diagram serves as an illustration of the workflow in software development.”

8. Practical Application

‘Practical application’ refers to a real-world use or implementation of a theory, concept, or technology. Example: “The practical application of these research findings can be seen in urban planning.”

9. Usage Scenario

‘Usage scenario’ is suitable for describing a specific context or condition in which a product or service would be used. Example: “The usage scenario we envision is for remote health monitoring systems in rural areas.”

10. Demonstration

Use ‘demonstration’ when showing how something works or is used, often in a practical, hands-on manner. Example: “The live demonstration of the software clearly showed its capabilities in managing large datasets.”

11. Usage Example

‘Usage example’ is a specific instance or case that illustrates how something can be used effectively. Example: “A usage example of this application is tracking delivery vehicles in real time.”

12. Application Scenario

‘Application scenario’ refers to a detailed and contextualized description of how a product or service could be utilized. Example: “An application scenario for this security system is in high-traffic retail environments.”

13. Functionality Example

‘Functionality example’ is used to illustrate how a particular feature or function of a system or product works. Example: “A functionality example of our new software is its ability to integrate seamlessly with existing tools.”

14. Operational Instance

Use ‘operational instance’ to describe a specific occasion or situation where a system or process is put into practice. Example: “An operational instance of this procedure is seen during emergency evacuations.”

15. Implementation Example

‘Implementation example’ is used for illustrating how a concept, plan, or system can be executed or realized. Example: “The implementation example of our environmental policy can be seen in the waste reduction measures at our facilities.”

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15 Best Case Study Templates to Use in Word and ClickUp

Praburam Srinivasan

Growth Marketing Manager

February 14, 2024

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Case studies are valuable tools for sharing customer success stories and analyzing problem-solving approaches in a structured and informative manner. They can be used to provide detailed insights into specific projects, strategies, or challenges and offer valuable lessons and best practices for professionals across various fields. 

Content marketing teams often create case studies as a way to gain more customers and get new business. Case studies can give potential customers a better understanding of your company brand , what it does and how you could potentially help them. 

However, creating a compelling case study from scratch can be a time-consuming task. That’s where marketing case study examples and templates can help. 

What is a Case Study Template?

What makes a good case study template, 1. clickup case study template, 2. clickup case study design template, 3. clickup research report template, 4. clickup market research template, 5. clickup user research plan template, 6. clickup data analysis findings template, 7. clickup campaign report template, 8. clickup research whiteboard, 9. google docs case study template by wordstream, 10. word case study report template by template.net, 11. word case brief summary template by template.net, 12. word case study report template by template.net, 13. word case study research template by template.net, 14. word psychology case study template by template.net, 15. word media case study template by template.net.

A case study template is a pre-designed framework that serves as a starting point for creating comprehensive and structured case study documents. It provides a standardized, traditional case study format for organizing and presenting information about a particular project, problem-solving scenario, success story, or real-life situation.

Case study templates typically include sections for outlining the background and context of the case study, project documentation , describing the methodology or approach used, presenting data and analysis, and highlighting key findings and recommendations that tell the entire story. 

Business case study examples like templates can work as a guide to help content marketers, blog post writers, and anyone else creating quality content that’s customer-facing, focus on important aspects and maintain a logical flow while telling a compelling story.

Some key elements that make a case study template stand out include:

• Clarity and organization: A well-designed template should be easy to navigate. Each section should be labeled appropriately, enabling readers to quickly find the information they seek
• Flexibility: A good case study template should be easily customizable and able to accommodate diverse scenarios. It should be adaptable to different industries, research methodologies, and presentation styles
• Visual appeal: Incorporating visual elements like charts, graphs, and other images can enhance a case study template’s look and make it more visually appealing. They can also aid in the comprehension of complex data. A visually engaging template can captivate readers and make the case study more impactful

15 Case Study Templates to Use in 2024

You don’t have to start from scratch when making your next case study. Instead, take a look at these carefully curated case study templates from ClickUp and Microsoft Word.

ClickUp’s Case Study Template can provide a great start for just about any type of case study you and your team want to write. It kicks off with a section for introducing both your business and the client or customer that the case study focuses on. 

After introducing both yourself and the customer, you briefly highlight the customer’s experience and the successes you achieved before delivering a more detailed description of the work you performed and the measurable results you achieved. 

The next section focuses on the objective of the case study—what the client’s goal and pain point was and why they decided you were the right company to help them achieve these goals. 

The case study template then launches into a section describing the solutions you presented and the data that backs up your success. We created this marketing case study template for a marketing agency that helps customers achieve growth through paid media campaigns, but it can easily be edited to highlight any type of solution.

One of the best ways of telling a customer story using a case study is by allowing the customer to do most of the work themselves. When a case study is written by current or even previous customers, it feels more sincere and honest, especially to potential customers in the evaluation process. 

If you want to try this technique out, use this ClickUp Study Design Template . You can send your customer this great case study template and allow them to fill it out themselves and basically write a case study for you. This gives you unfiltered and unbiased answers to the questions you want answered in the case study. 

The case study template helps them understand what you want the case study to look like and how the customer’s story should be described. It also helps you get great customer quotes. 

A template makes it easier for your customer to frame their experiences with you and easily explain how your product or service helped them. Hearing a peer’s success story from a firsthand perspective can be a more convincing read for prospective customers. 

Manage customers with customer database software !

Case studies are essentially customer stories, which can be told in many ways and come in many formats. A research report is another excellent way to frame a case study. 

This ClickUp Research Report Template is a step-by-step guide that can help your team create an easy-to-follow research report that allows you to clearly detail your research methods, findings, and the insights that you’ve gained from the research being presented. 

This template has a very clear structure, allowing you to simply add the following: an executive summary (brief description), introduction, the methodology used, your results, references, and any necessary appendices if supplementary material needs to be referenced in your research report. 

If you need more templates like this, check out this list of research plan templates .

Companies perform market research in order to define what their customers want and need from them. This type of research also helps you to improve product and service offers and learn more about what your competitors are doing and where the success of other businesses stems from. 

ClickUp’s Market Research Template gives you a simple-to-follow document that helps you gather and present information related to your target audience, the state of your product/service, and the state of your industry at large. 

When you perform marketing research, you are aiming to confirm your hunches about customer needs through scientific research and tangible data. 

Marketing case study examples like this are perfect because they’re very simplified and easily customizable. It offers you a section for presenting your company and why you are performing marketing research first.

The template then guides you in describing the type of research you’re doing, how you went about performing market research, data collection techniques, and what insights were garnered—whether it was from existing or potential customers.

Check out these research management tools !

Another type of customer-centric report that you can put together is a user research report. ClickUp’s User Research Plan Template makes it easy for you to define all of the goals and details that you want included in your user research.

The template is particularly useful for user experience (UX) teams that want to perform user persona research in order to better understand what users need and how they behave when using their product, in order to deliver a better experience to them and to new clients. 

The template starts with a “ problem statement ” where you can define the problem that the user research report is aiming to solve. Next, you’ll list the goals that you want to achieve and then clearly define the research process.

This type of marketing case study template and report can show you what a satisfied customer looks like and give you insights that help to attract and retain future customers.

Check out these user persona templates !

Another important study that your business can perform in order to make smarter decisions is data analysis. ClickUp’s Data Analysis Findings template makes it easy for your team to perform data analysis and present it clearly to key stakeholders. 

This template also starts by setting the stage for the study and explaining it, first with a problem statement and then by explaining the significance of the study. 

Next, the template recommends that you define the scope and limitations of the study to set expectations for its potential impact. The next step is to frame your analysis methods and provide the data sources that you used in the analysis, as well as the statistical methods used.

Finally, you can present your findings in a clear and concise way. The template also includes charts and other data visualization tools you can use to make the study more engaging.

This ClickUp Campaign Report template is pre-built to make it incredibly easy to present the results of any ad campaign to stakeholders very easily. 

It starts with a section describing your strategy in detail, including the total costs, and the total revenue, conversions, and clicks that you expect to achieve with the campaign. 

The marketing case study template then provides charts and graphs that you can use to detail the performance of your campaigns on every single channel that you use. Case study templates like this are great for detailing information on potential customers to know how to better run your campaigns in the future.

Make your next user research project a collaborative, visual experience. Give everyone on your team a chance to add their thoughts and findings with virtual sticky notes using the ClickUp Research Whiteboard Template .

This is one of the more flexible case study templates in this list. Its user research tool makes it easy to take all the random bits of information your team gathers through interviews, surveys, user sessions, and other methods of feedback into one location.

Then, you can quickly organize all of that data into clear categories that make this case study template easy to see at a glance what direction you need to take your project to satisfy your customers.

If you’re writing many case studies, it’s a good idea to try out a bunch of templates over time for added inspiration. Even if you’ve found one structure works great for your case studies, changing your structure up every now and then can give you a fresh perspective on how to present a featured client. 

Another good case study you can check out is Wordstream’s Case Study Template. It has an excellent structure and provides pre-built visual cues that give you some ideas for breaking up business case study examples and making them more appealing with pictures and charts. 

Use this template to showcase particular customers’ results and share customer pain points and how they were solved. This will help you provide clear evidence to potential customers that you will be able to help them as well.

Template.net is one of the biggest websites if you’re looking for business templates. It’s especially popular for businesses that prefer creating documents in Microsoft Word and Excel.

This Case Study Template from Template.net is sparse, but it gets right to the point and is very well-structured and easy to follow.

This Microsoft Word case study template is a great way to get right down to business! It features a clean and organized layout with clear headings and subheadings, making it easy for readers to navigate. This template also includes space for a brief summary of the case study, perfect for giving readers an overview before diving into the details.

This Microsoft Word case study template is a great option for creating an in-depth report on your findings. The template includes sections for an executive summary, introduction, methodology, results, references, and appendices. It also features a clear structure to make it easy to gather and present information in a cohesive manner. The template also includes sections for an introduction, methodology, findings, and recommendations, ensuring that all the essential elements of a case study are covered.

This Word case study template features a professional and organized design with clearly labeled sections for the introduction, methodology, findings, and conclusion. It also includes space for charts and graphs to visually represent data.

Psychology case studies can be complex and detailed, making it important to have a well-organized template to present the information. The Psychology Case Study Template is perfect for this task, with clear headings and subheadings that guide readers through each section of the study. It also includes sections for summarizing key points and providing recommendations based on the findings.

This media case study template from Template.net is perfect for showcasing the success of a marketing or advertising campaign! It includes space for key metrics, such as reach and engagement, and also has sections for outlining the challenges faced and solutions implemented. With its clean design and easy-to-follow layout, this template is ideal for presenting media case studies to clients or stakeholders.

It’s Easy to Make a Case for Using ClickUp Case Study Templates

People trust other people. That’s why personal recommendations are one of the most effective marketing tactics. A case study provides your company with just that—a personal recommendation from a client you’ve helping, telling others that you can do the same for them. 

In the selection process of choosing a product or service to go with, companies will always look at the experiences of other organizations similar to them. Marketing case studies are sincere yet persuasive and clearly show how you help others and can be a very effective differentiator.

ClickUp was designed to serve teams in any industry and of any size. So it makes sense the case study templates we offer are just as diverse and customizable.

Best of all, they are completely free to use!  Sign up for free to ClickUp to get immediate access to a massive amount of templates, free cloud storage, and of course, industry-leading project and team management features.

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• Rhymes with Case-study
• Case-study in a sentence

Study Past Tense

The past tense of Study is studied.

noun. ['ˈstʌdi'] a detailed critical inspection.

• examination
• indiscipline
• Romanticism
• studie (Middle English (1100-1500))
• estudier (Old French (842-ca. 1400))

Rhymes with Case Study

Sentences with case-study.

1. Noun Phrase For these questions, a case study is provided for analysis. 2. Noun Phrase This might be a real-world scenario or a case ," aria-label="Link to study ,"> study , depending on the specific course requirements.

verb. ['ˈstʌdi'] consider in detail and subject to an analysis in order to discover essential features or meaning.

• check up on
• investigate

verb. ['ˈstʌdi'] be a student; follow a course of study; be enrolled at an institute of learning.

noun. ['ˈstʌdi'] applying the mind to learning and understanding a subject (especially by reading).

• acquisition

verb. ['ˈstʌdi'] give careful consideration to.

• contemplate

verb. ['ˈstʌdi'] be a student of a certain subject.

noun. ['ˈkeɪs'] an occurrence of something.

• mortification
• natural event
• humiliation
• postmeridian
• antemeridian
• cas (Middle English (1100-1500))
• cas (Old English (ca. 450-1100))

noun. ['ˈkeɪs'] a special set of circumstances.

noun. ['ˈkeɪs'] a comprehensive term for any proceeding in a court of law whereby an individual seeks a legal remedy.

• class action
• countersuit
• bastardy proceeding
• proceedings
• class-action suit
• criminal suit
• legal proceeding
• paternity suit
• motionlessness
• stand still
• distributed

noun. ['ˈkeɪs'] the actual state of things.

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Meaning of case study in English

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• anti-narrative
• be another story idiom
• bodice-ripper
• cautionary tale
• in medias res
• misdescription
• running commentary phrase
• semi-legendary
• shaggy-dog story
• write something up

case study | American Dictionary

Case study | business english, examples of case study, translations of case study.

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the left wing

the political left

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• a study of an individual unit, as a person, family, or social group, usually emphasizing developmental issues and relationships with the environment, especially in order to compare a larger group to the individual unit.
• case history .
• the act or an instance of analysing one or more particular cases or case histories with a view to making generalizations

Word History and Origins

Origin of case study 1

Example Sentences

In a case study from Metric Theory, Target Impression Share bidding, the total cost per click increased with both mobile and desktop devices.

It would also become the subject of a fair number of business school case studies.

Not just blog posts, you can also share other resources like case studies, podcast episodes, and webinars via Instagram Stories.

They become the architecture for a case study of Flint, expressed in a more personal and poetic way than a straightforward investigation could.

The Creek Fire was a case study in the challenge facing today’s fire analysts, who are trying to predict the movements of fires that are far more severe than those seen just a decade ago.

A case study would be your Twilight director Catherine Hardwicke.

A good case study for the minority superhero problem is Luke Cage.

He was asked to review a case study out of Lebanon that had cited his work.

Instead, now we have a political science case-study proving how political fortunes can shift and change at warp speed.

One interesting case study is Sir Arthur Evans, the original excavator and “restorer” of the Minoan palace of Knossos on Crete.

As this is a case study, it should be said that my first mistake was in discrediting my early religious experience.

The author of a recent case study of democracy in a frontier county commented on the need for this kind of investigation.

How could a case study of Virginia during this period illustrate these developments?

Related Words

• medical history

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Home » Case Study – Methods, Examples and Guide

Case Study – Methods, Examples and Guide

Table of Contents

A case study is a research method that involves an in-depth examination and analysis of a particular phenomenon or case, such as an individual, organization, community, event, or situation.

It is a qualitative research approach that aims to provide a detailed and comprehensive understanding of the case being studied. Case studies typically involve multiple sources of data, including interviews, observations, documents, and artifacts, which are analyzed using various techniques, such as content analysis, thematic analysis, and grounded theory. The findings of a case study are often used to develop theories, inform policy or practice, or generate new research questions.

Types of Case Study

Types and Methods of Case Study are as follows:

Single-Case Study

A single-case study is an in-depth analysis of a single case. This type of case study is useful when the researcher wants to understand a specific phenomenon in detail.

For Example , A researcher might conduct a single-case study on a particular individual to understand their experiences with a particular health condition or a specific organization to explore their management practices. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a single-case study are often used to generate new research questions, develop theories, or inform policy or practice.

Multiple-Case Study

A multiple-case study involves the analysis of several cases that are similar in nature. This type of case study is useful when the researcher wants to identify similarities and differences between the cases.

For Example, a researcher might conduct a multiple-case study on several companies to explore the factors that contribute to their success or failure. The researcher collects data from each case, compares and contrasts the findings, and uses various techniques to analyze the data, such as comparative analysis or pattern-matching. The findings of a multiple-case study can be used to develop theories, inform policy or practice, or generate new research questions.

Exploratory Case Study

An exploratory case study is used to explore a new or understudied phenomenon. This type of case study is useful when the researcher wants to generate hypotheses or theories about the phenomenon.

For Example, a researcher might conduct an exploratory case study on a new technology to understand its potential impact on society. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as grounded theory or content analysis. The findings of an exploratory case study can be used to generate new research questions, develop theories, or inform policy or practice.

Descriptive Case Study

A descriptive case study is used to describe a particular phenomenon in detail. This type of case study is useful when the researcher wants to provide a comprehensive account of the phenomenon.

For Example, a researcher might conduct a descriptive case study on a particular community to understand its social and economic characteristics. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of a descriptive case study can be used to inform policy or practice or generate new research questions.

Instrumental Case Study

An instrumental case study is used to understand a particular phenomenon that is instrumental in achieving a particular goal. This type of case study is useful when the researcher wants to understand the role of the phenomenon in achieving the goal.

For Example, a researcher might conduct an instrumental case study on a particular policy to understand its impact on achieving a particular goal, such as reducing poverty. The researcher collects data from multiple sources, such as interviews, observations, and documents, and uses various techniques to analyze the data, such as content analysis or thematic analysis. The findings of an instrumental case study can be used to inform policy or practice or generate new research questions.

Case Study Data Collection Methods

Here are some common data collection methods for case studies:

Interviews involve asking questions to individuals who have knowledge or experience relevant to the case study. Interviews can be structured (where the same questions are asked to all participants) or unstructured (where the interviewer follows up on the responses with further questions). Interviews can be conducted in person, over the phone, or through video conferencing.

Observations

Observations involve watching and recording the behavior and activities of individuals or groups relevant to the case study. Observations can be participant (where the researcher actively participates in the activities) or non-participant (where the researcher observes from a distance). Observations can be recorded using notes, audio or video recordings, or photographs.

Documents can be used as a source of information for case studies. Documents can include reports, memos, emails, letters, and other written materials related to the case study. Documents can be collected from the case study participants or from public sources.

Surveys involve asking a set of questions to a sample of individuals relevant to the case study. Surveys can be administered in person, over the phone, through mail or email, or online. Surveys can be used to gather information on attitudes, opinions, or behaviors related to the case study.

Artifacts are physical objects relevant to the case study. Artifacts can include tools, equipment, products, or other objects that provide insights into the case study phenomenon.

How to conduct Case Study Research

Conducting a case study research involves several steps that need to be followed to ensure the quality and rigor of the study. Here are the steps to conduct case study research:

• Define the research questions: The first step in conducting a case study research is to define the research questions. The research questions should be specific, measurable, and relevant to the case study phenomenon under investigation.
• Select the case: The next step is to select the case or cases to be studied. The case should be relevant to the research questions and should provide rich and diverse data that can be used to answer the research questions.
• Collect data: Data can be collected using various methods, such as interviews, observations, documents, surveys, and artifacts. The data collection method should be selected based on the research questions and the nature of the case study phenomenon.
• Analyze the data: The data collected from the case study should be analyzed using various techniques, such as content analysis, thematic analysis, or grounded theory. The analysis should be guided by the research questions and should aim to provide insights and conclusions relevant to the research questions.
• Draw conclusions: The conclusions drawn from the case study should be based on the data analysis and should be relevant to the research questions. The conclusions should be supported by evidence and should be clearly stated.
• Validate the findings: The findings of the case study should be validated by reviewing the data and the analysis with participants or other experts in the field. This helps to ensure the validity and reliability of the findings.
• Write the report: The final step is to write the report of the case study research. The report should provide a clear description of the case study phenomenon, the research questions, the data collection methods, the data analysis, the findings, and the conclusions. The report should be written in a clear and concise manner and should follow the guidelines for academic writing.

Examples of Case Study

Here are some examples of case study research:

• The Hawthorne Studies : Conducted between 1924 and 1932, the Hawthorne Studies were a series of case studies conducted by Elton Mayo and his colleagues to examine the impact of work environment on employee productivity. The studies were conducted at the Hawthorne Works plant of the Western Electric Company in Chicago and included interviews, observations, and experiments.
• The Stanford Prison Experiment: Conducted in 1971, the Stanford Prison Experiment was a case study conducted by Philip Zimbardo to examine the psychological effects of power and authority. The study involved simulating a prison environment and assigning participants to the role of guards or prisoners. The study was controversial due to the ethical issues it raised.
• The Challenger Disaster: The Challenger Disaster was a case study conducted to examine the causes of the Space Shuttle Challenger explosion in 1986. The study included interviews, observations, and analysis of data to identify the technical, organizational, and cultural factors that contributed to the disaster.
• The Enron Scandal: The Enron Scandal was a case study conducted to examine the causes of the Enron Corporation’s bankruptcy in 2001. The study included interviews, analysis of financial data, and review of documents to identify the accounting practices, corporate culture, and ethical issues that led to the company’s downfall.
• The Fukushima Nuclear Disaster : The Fukushima Nuclear Disaster was a case study conducted to examine the causes of the nuclear accident that occurred at the Fukushima Daiichi Nuclear Power Plant in Japan in 2011. The study included interviews, analysis of data, and review of documents to identify the technical, organizational, and cultural factors that contributed to the disaster.

Application of Case Study

Case studies have a wide range of applications across various fields and industries. Here are some examples:

Business and Management

Case studies are widely used in business and management to examine real-life situations and develop problem-solving skills. Case studies can help students and professionals to develop a deep understanding of business concepts, theories, and best practices.

Case studies are used in healthcare to examine patient care, treatment options, and outcomes. Case studies can help healthcare professionals to develop critical thinking skills, diagnose complex medical conditions, and develop effective treatment plans.

Case studies are used in education to examine teaching and learning practices. Case studies can help educators to develop effective teaching strategies, evaluate student progress, and identify areas for improvement.

Social Sciences

Case studies are widely used in social sciences to examine human behavior, social phenomena, and cultural practices. Case studies can help researchers to develop theories, test hypotheses, and gain insights into complex social issues.

Law and Ethics

Case studies are used in law and ethics to examine legal and ethical dilemmas. Case studies can help lawyers, policymakers, and ethical professionals to develop critical thinking skills, analyze complex cases, and make informed decisions.

Purpose of Case Study

The purpose of a case study is to provide a detailed analysis of a specific phenomenon, issue, or problem in its real-life context. A case study is a qualitative research method that involves the in-depth exploration and analysis of a particular case, which can be an individual, group, organization, event, or community.

The primary purpose of a case study is to generate a comprehensive and nuanced understanding of the case, including its history, context, and dynamics. Case studies can help researchers to identify and examine the underlying factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and detailed understanding of the case, which can inform future research, practice, or policy.

Case studies can also serve other purposes, including:

• Illustrating a theory or concept: Case studies can be used to illustrate and explain theoretical concepts and frameworks, providing concrete examples of how they can be applied in real-life situations.
• Developing hypotheses: Case studies can help to generate hypotheses about the causal relationships between different factors and outcomes, which can be tested through further research.
• Providing insight into complex issues: Case studies can provide insights into complex and multifaceted issues, which may be difficult to understand through other research methods.
• Informing practice or policy: Case studies can be used to inform practice or policy by identifying best practices, lessons learned, or areas for improvement.

Advantages of Case Study Research

There are several advantages of case study research, including:

• In-depth exploration: Case study research allows for a detailed exploration and analysis of a specific phenomenon, issue, or problem in its real-life context. This can provide a comprehensive understanding of the case and its dynamics, which may not be possible through other research methods.
• Rich data: Case study research can generate rich and detailed data, including qualitative data such as interviews, observations, and documents. This can provide a nuanced understanding of the case and its complexity.
• Holistic perspective: Case study research allows for a holistic perspective of the case, taking into account the various factors, processes, and mechanisms that contribute to the case and its outcomes. This can help to develop a more accurate and comprehensive understanding of the case.
• Theory development: Case study research can help to develop and refine theories and concepts by providing empirical evidence and concrete examples of how they can be applied in real-life situations.
• Practical application: Case study research can inform practice or policy by identifying best practices, lessons learned, or areas for improvement.
• Contextualization: Case study research takes into account the specific context in which the case is situated, which can help to understand how the case is influenced by the social, cultural, and historical factors of its environment.

Limitations of Case Study Research

There are several limitations of case study research, including:

• Limited generalizability : Case studies are typically focused on a single case or a small number of cases, which limits the generalizability of the findings. The unique characteristics of the case may not be applicable to other contexts or populations, which may limit the external validity of the research.
• Biased sampling: Case studies may rely on purposive or convenience sampling, which can introduce bias into the sample selection process. This may limit the representativeness of the sample and the generalizability of the findings.
• Subjectivity: Case studies rely on the interpretation of the researcher, which can introduce subjectivity into the analysis. The researcher’s own biases, assumptions, and perspectives may influence the findings, which may limit the objectivity of the research.
• Limited control: Case studies are typically conducted in naturalistic settings, which limits the control that the researcher has over the environment and the variables being studied. This may limit the ability to establish causal relationships between variables.
• Time-consuming: Case studies can be time-consuming to conduct, as they typically involve a detailed exploration and analysis of a specific case. This may limit the feasibility of conducting multiple case studies or conducting case studies in a timely manner.
• Resource-intensive: Case studies may require significant resources, including time, funding, and expertise. This may limit the ability of researchers to conduct case studies in resource-constrained settings.

About the author

Muhammad Hassan

Researcher, Academic Writer, Web developer

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noun as in learning, analysis

Strongest matches

application , class , consideration , course , debate , examination , exercise , inquiry , inspection , investigation , research , review , subject , survey

Strong matches

abstraction , analyzing , attention , cogitation , comparison , concentration , contemplation , cramming , deliberation , lesson , meditation , memorizing , muse , musing , pondering , questioning , reading , reasoning , reflection , reverie , rumination , schoolwork , scrutiny , thought , trance , weighing

academic work

verb as in contemplate, learn

consider , examine , learn , ponder , pore over , read , think

coach , cogitate , cram , dig , excogitate , grind , inquire , lucubrate , meditate , mind , peruse , plug , plunge , refresh , tutor , weigh

Weak matches

apply oneself , bone up , brood over , burn midnight oil , bury oneself in , crack the books , dive into , go into , go over , hit the books , learn the ropes , mull over , perpend , polish up , read up , think out , think over

verb as in examine, analyze

inspect , investigate , read , research , scrutinize , survey , view

brainstorm , canvass , case , compare , deliberate , figure , peruse , scope

check out , check over , check up , do research , give the eagle eye , keep tabs , look into , sort out

Example Sentences

Those studies are scheduled for completion over about the next year and a half.

The study tallied activity in more than a dozen different cryptocurrencies.

More recently, studies have reported on what the infection might do to the heart.

That’s according to a new study published in Science Advances.

The study, published Friday in the journal Environmental Research Letters, found this association in both rural counties in Louisiana and highly populated communities in New York.

She completed a yoga teacher-training program and, in the spring of 2008, went on a retreat in Peru to study with shamans.

In fact, in a recent study of their users internationally, it was the lowest priority for most.

But in the case of black women, another study found no lack of interest.

Indeed, study after study affirms the benefits of involved fatherhood for women and children.

A recent U.S. study found men get a “daddy bonus” —employers seem to like men who have children and their salaries show it.

"There's just one thing I'd like to ask, if you don't mind," said Cynthia, coming suddenly out of a brown study.

His lordship retired shortly to his study, Hetton and Mr. Haggard betook themselves to the billiard-room.

She began the study of drawing at the age of thirty, and her first attempt in oils was made seven years later.

In practice we find a good deal of technical study comes into the college stage.

Its backbone should be the study of biology and its substance should be the threshing out of the burning questions of our day.

Related Words

Words related to study are not direct synonyms, but are associated with the word study . Browse related words to learn more about word associations.

noun as in careful considering

• calculation
• consideration
• deliberation

noun as in nook, secluded spot

• compartment

noun as in statement of results from examination

• interpretation

noun as in examination and determination

• dissolution
• investigation
• subdivision

Viewing 5 / 196 related words

From Roget's 21st Century Thesaurus, Third Edition Copyright © 2013 by the Philip Lief Group.

Title Case Capitalization

APA Style uses two types of capitalization for titles of works (such as paper titles ) and headings within works : title case and sentence case .

In title case, major words are capitalized, and most minor words are lowercase. In sentence case, most major and minor words are lowercase ( proper nouns are an exception in that they are always capitalized).

• major words: Nouns, verbs (including linking verbs), adjectives, adverbs, pronouns, and all words of four letters or more are considered major words.
• minor words: Short (i.e., three letters or fewer) conjunctions, short prepositions, and all articles are considered minor words.

Title case capitalization is covered in the seventh edition APA Style manuals in the Publication Manual Section 6.17 and the Concise Guide Section 5.7

How to implement title case

In title case, capitalize the following words in a title or heading:

• the first word of the title or heading, even if it is a minor word such as “The” or “A”
• the first word of a subtitle
• the first word after a colon, em dash, or end punctuation in a heading
• major words, including the second part of hyphenated major words (e.g., “Self-Report,” not “Self-report”)
• words of four letters or more (e.g., “With,” “Between,” “From”)

Lowercase only minor words that are three letters or fewer in a title or heading (except the first word in a title or subtitle or the first word after a colon, em dash, or end punctuation in a heading):

• short conjunctions (e.g., “and,” “as,” “but,” “for,” “if,” “nor,” “or,” “so,” “yet”)
• articles (“a,” “an,” “the”)
• short prepositions (e.g., “as,” “at,” “by,” “for,” “in,” “of,” “off,” “on,” “per,” “to,” “up,” “via”)

When to use title case

Use title case for the following:

• titles of articles, books, reports, and other works appearing in text

In the book Train Your Mind for Peak Performance: A Science-Based Approach for Achieving Your Goals

In the article “Turning Frowns (and Smiles) Upside Down: A Multilevel Examination of Surface Acting Positive and Negative Emotions on Well-Being”

• titles of tests or measures, including subscales

Beck Depression Inventory–II

• all headings within a work (Levels 1–5; these are also bold or bold italic)
• the title of your own paper and of named sections and subsections within it

the Results section

• titles of periodicals (these are also italicized)

Journal of Latinx Psychology

Chicago Tribune

• table titles (these are also italicized)
• figure titles (these are also italicized), axis labels, and legends

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Synonyms for Use case

54 other terms for use case - words and phrases with similar meaning.

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2024 Paris Olympics

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Phryge, the mascot of the Paris 2024 Olympic Games, cheers at the women's group B match between the U.S. and Zambia on Thursday. Marc Atkins/Getty Images hide caption

The Paris Olympics are finally here. More than 10,000 athletes have descended on the French capital for more than two weeks of competition, patriotism and potential drama. NPR’s own Olympics team will bring you recaps, coverage and color — including on the ground in Paris — online and on air over the next few weeks.

What’s that thumping sound in Paris? A dramatic new pre-game Olympics custom

Emma Bowman

Dan O'Brien, a former American decathlete, bears the brigadier ahead of the High Jump portion of the Decathlon at Stade de France on Friday. He's about to command the attention of the stadium's raucous crowd as part of a new, very French Olympic custom. Hannah Peters/Getty Images hide caption

NPR is in Paris for the 2024 Summer Olympics. For more of our coverage from the Games, head to our latest updates.

PARIS — Minutes before tipoff at a men’s 3-on-3 basketball game, a curious act unfolded.

Two men walked onto the court, with them a tall, wooden staff. You could tell by their garb they were not Olympic athletes.

In a league of his own, shot-putter Ryan Crouser wins U.S. 3rd Olympic gold in a row

Then, slowly, thump-thump-thump .

The pair passed the thick stick back and forth, taking it to pound the floor each time.

The three blows thundered through the outdoor stadium, hushing the buzzy crowd. Upon its conclusion, the spectators broke into applause.

The men who had effectively commanded the crowd with three easy strikes of a baton were Bruno Gouery and William Abadie — French actors recognizable from the Netflix show Emily in Paris .

It was at once all very light-hearted and serious. Come to find out, the practice is borrowed from the dramatic arts.

It's called the “three ground strikes" — or, les trois coups, s'il vous plait. It’s a new, fittingly French, Olympics ritual that was introduced for the first time this year at the Paris Games.

What's inside the mysterious boxed gift Olympic winners get with their medals

The custom is borrowed from an ages-old practice found on French performance stages. But at the Paris Games , it's meant to connect spectators with athletes, and to celebrate the host country's theatrical heritage, organizers say.

The trois coups happens at the top of each sporting session at Olympic venues to mark the start of play.

The honors aren't strictly bestowed to Emily in Paris cast members.

A "former or current" sportsman or sportswoman, a volunteer, public figure or often a completely anonymous person may commence les trois coups, according to organizers.

Daniel Carter, retired New Zealand rugby player, bears the brigadier upon entering the stadium during the Men's Rugby Sevens group match between Australia and Samoa at Stade de France on July 24, 2024. Hannah Peters/Getty Images hide caption

Tennis great Billie Jean King performed the three-strikes ritual ahead of the Rafael Nadal-Carlos Alcaraz doubles match at Roland Garros. Indian Olympic gold medalist Abhinav Bindra tapped the stick signal the start of Ramita Jindal’s 10-meter air rifle event.

From the French theater to the Olympic venue

The custom was, and in many cases continues to be, present in French classical theater.

But there's a lot of disagreement about the origins' specifics, including the number of strikes that should be deployed.

Some scholars say trois coups harkens back to France's first professional theater, during the Middle Ages, when it was said to evoke religious symbolism — the three blows representing the Holy Trinity.

Simone Biles wins her 3rd gold of the 2024 Olympics with the vault named after her

Others put forth a secular take. Paul Gousset, a former technical director of the Royal Opera of Versailles, has explained the use of the three blows before a stage play “as signaling a final check that all was in readiness to begin the production,” according to researcher Marvin Carlson .

By Gousset's telling, the series of blows was used to communicate not to the audience but to the backstage crew: "the head technicians above the stage, below it, and on the side opposite the brigadier, would each give a single blow to show that their area was ready to proceed," wrote Carlson.

The stick used to command the crowd is called a “brigadier.” A brigadier is usually used to describe one who commands a military brigade, yes, but does not a stage manager lead his theater brigade?

Why are Olympic swimmers bundled up like they're competing in the Winter Games?

That’s the idea, according to organizers. It was a term used so often to refer to a stick-wielding stage manager that, through the magic of metonymy, the stick itself is now referred to as a brigadier.

But what of its use in athleticism today? The ritual is meant to leave fans with a little souvenir of French culture, bring together theater and sport, and to effectively tell the crowd: Silence — you’re about to see a thrilling show.

“These three strokes are designed to remind us that each event is a unique performance that deserves the public's attention and respect," the Olympics website says . "Spectators are invited to observe a moment of silence at the moment of the three blows, just like in the theatre."

• Paris Olympics 2024

How to Use case study in a Sentence

• The company's recent history is a case study in bad management.

Some of these examples are programmatically compiled from various online sources to illustrate current usage of the word 'case study.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

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Embracing Gen AI at Work

• H. James Wilson
• Paul R. Daugherty

The skills you need to succeed in the era of large language models

Today artificial intelligence can be harnessed by nearly anyone, using commands in everyday language instead of code. Soon it will transform more than 40% of all work activity, according to the authors’ research. In this new era of collaboration between humans and machines, the ability to leverage AI effectively will be critical to your professional success.

This article describes the three kinds of “fusion skills” you need to get the best results from gen AI. Intelligent interrogation involves instructing large language models to perform in ways that generate better outcomes—by, say, breaking processes down into steps or visualizing multiple potential paths to a solution. Judgment integration is about incorporating expert and ethical human discernment to make AI’s output more trustworthy, reliable, and accurate. It entails augmenting a model’s training sources with authoritative knowledge bases when necessary, keeping biases out of prompts, ensuring the privacy of any data used by the models, and scrutinizing suspect output. With reciprocal apprenticing, you tailor gen AI to your company’s specific business context by including rich organizational data and know-how into the commands you give it. As you become better at doing that, you yourself learn how to train the AI to tackle more-sophisticated challenges.

The AI revolution is already here. Learning these three skills will prepare you to thrive in it.

Generative artificial intelligence is expected to radically transform all kinds of jobs over the next few years. No longer the exclusive purview of technologists, AI can now be put to work by nearly anyone, using commands in everyday language instead of code. According to our research, most business functions and more than 40% of all U.S. work activity can be augmented, automated, or reinvented with gen AI. The changes are expected to have the largest impact on the legal, banking, insurance, and capital-market sectors—followed by retail, travel, health, and energy.

• H. James Wilson is the global managing director of technology research and thought leadership at Accenture Research. He is the coauthor, with Paul R. Daugherty, of Human + Machine: Reimagining Work in the Age of AI, New and Expanded Edition (HBR Press, 2024). hjameswilson
• Paul R. Daugherty is Accenture’s chief technology and innovation officer. He is the coauthor, with H. James Wilson, of Human + Machine: Reimagining Work in the Age of AI, New and Expanded Edition (HBR Press, 2024). pauldaugh

Partner Center

• Open access
• Published: 10 August 2024

Performance of calf circumference in identifying sarcopenia in older patients with chronic low back pain: a retrospective cross-sectional study

• Hee Jung Kim 1 ,
• Ji Young Kim 1 &
• Shin Hyung Kim   ORCID: orcid.org/0000-0003-4058-7697 1  

BMC Geriatrics volume  24 , Article number:  674 ( 2024 ) Cite this article

200 Accesses

Metrics details

Calf circumference is currently recommended as a case-finding marker for sarcopenia, but its usefulness has not been determined in chronic pain conditions. Therefore, the present study aimed to evaluate the predictive performance of calf circumference in diagnosing sarcopenia in older patients with chronic low back pain.

Ambulatory adult patients aged ≥ 65 years with chronic low back pain were enrolled. A diagnosis of sarcopenia was established based on the criteria outlined by the Asian Working Group for Sarcopenia in 2019. Patient demographics, pain-related factors, clinical factors, and sarcopenia-related measurements were compared between non-sarcopenic and sarcopenic patients. Linear regression analysis was used to evaluate the correlation of calf circumference with muscle mass, strength, and physical performance. Also, a receiver operating characteristic curve analysis for calf circumference in predicting sarcopenia was conducted; and area under the curve (AUC) values, along with their corresponding 95% confidence intervals (CI), were calculated.

Data from 592 patients were included in the analysis. Eighty-five patients were diagnosed with sarcopenia (14.3%), 71 of whom had severe sarcopenia (11.9%). A higher prevalence of sarcopenia was observed in female patients (9.0% vs. 16.7%, p  = 0.016). After adjusting for age, BMI, and comorbidities, calf circumference correlated positively with muscle mass but not with muscle strength and physical performance. The AUC values for sarcopenia were 0.754 (95% CI = 0.636–0.871, p  = 0.001) in males and 0.721 (95% CI = 0.657–0.786, p  < 0.001) in females. The cut-offs for calf circumference in predicting sarcopenia were 34 cm (sensitivity 67.1%, specificity 70.6%) in males, and 31 cm (sensitivity 82.5%, specificity 51.5%) in females.

Conclusions

Even though sex differences in its predictive value for sarcopenia should be considered, our findings suggest that calf circumference can be used as an indicator for predicting muscle mass and may serve as a potential marker for identifying sarcopenia in older patients with chronic low back pain.

Peer Review reports

Sarcopenia is currently defined as the decline in skeletal muscle mass and strength that occurs with advancing age and is often accompanied by diminished physical performance in its severe form [ 1 , 2 ]. Sarcopenia is associated with adverse health outcomes, including increased risk of falls and fractures, higher rates of hospitalization, and elevated mortality risk [ 1 , 3 ]. This condition is an increasing problem in our aging society; thus, sarcopenia prevention, treatment, and rehabilitation have become significant public health concerns when considering the economic and societal burden of sarcopenia. [ 3 , 4 ].

Chronic low back pain (CLBP) is one of the most common and major disabling health conditions among older adult populations [ 5 ]. The prevalence of sarcopenia among older patients with CLBP seems to be somewhat higher than in patients without pain [ 6 ]. Also, sarcopenia is associated with poor CLBP treatment outcomes [ 6 , 7 ]. Therefore, early identification of older patients at risk of sarcopenia is important for those with CLBP.

In the Asian Working Group for Sarcopenia 2019 (AWGS 2019) guidelines, calf circumference is recommended as an anthropometric measurement for identifying sarcopenia, facilitating early detection in older adults [ 1 ]. The role of calf circumference in the diagnosis algorithm for sarcopenia is supported by validation reports [ 8 , 9 , 10 , 11 , 12 , 13 ]. Calf circumference demonstrated a positive correlation with skeletal muscle mass assessed through dual-energy X-ray absorptiometry [ 8 , 9 , 10 , 11 , 12 ] and was also significantly associated with both muscle strength and physical performance [ 12 ]. However, these results were obtained from samples of the community-dwelling older population [ 12 ]. In recent reports, calf circumference showed promise for the screening for sarcopenia in subgroups with several comorbidities such as stroke, Parkinson’s disease, and diabetes [ 14 , 15 , 16 ]. However, the usefulness of calf circumference as a screening marker for sarcopenia has not been investigated in older patients with symptomatic degenerative lumbar spinal disease.

Accordingly, the aims of this study were to determine calf circumference cut-off values for sarcopenia prediction in older patients with CLBP and to evaluate its diagnostic performance using AWGS 2019 criteria. Also, the relationship between calf circumference and skeletal muscle mass, muscle strength, and physical performance was investigated in this population.

Study population

This study received approval from the Institutional Review Board of Yonsei University Health System, Seoul, Republic of Korea (IRB No. 4-2024-0094). In our previous studies, we have observed that low handgrip strength and high fat infiltration of paraspinal muscles resulted in poor treatment outcomes in older patients with CLBP [ 17 , 18 ]. Therefore, in 2022, we began sarcopenia screening and diagnosis for older patients with chronic pain at their initial visit to our pain clinic. The present study employs a retrospective cross-sectional observational design. Specifically, it is a retrospective audit of CLBP patients who completed sarcopenia assessment based on the AWGS 2019 diagnostic protocol. Patients who visited our clinic seeking treatment for low back pain from January to December 2022 were enrolled in the study. Based on the patho-anatomical approach of CLBP used for confirmation [ 19 ], adult patients aged 65 years and above diagnosed with degenerative lumbar spinal disease, such as spondylolisthesis, herniated disc, spinal/foraminal stenosis, and facet joint arthropathy, confirmed by radiological evaluation within one year from the date of initial visit were included. Pain duration of three months or longer was used to define chronicity. Non-ambulatory patients or patients with severe cognitive impairment that precluded completion of the sarcopenia assessment protocol were excluded. Patients with abnormal calf asymmetry with a difference in circumference greater than 2.0 cm between calves [ 20 ] or pitting edema of the lower limbs were excluded. To assess lower limb pitting edema, visual inspection for swelling or skin changes, gentle palpation to assess skin indentation, and observation for persistence of indentation after pressure release were conducted. In addition, patients with incomplete medical records for this study were excluded.

Sarcopenia assessment

All measurements followed standard protocols for each measurement based on AWGS 2019 recommendations [ 1 ]. An independent nurse practitioner experienced in comprehensive geriatric assessment conducted all measurements throughout the study period. Calf circumference was measured at the widest part of both calves using a non-elastic tape to capture the maximum value. Patients were instructed to stand with their feet shoulder-width apart to ensure equal distribution of body weight. The tape was applied snugly but without compressing the calf and was positioned flat on the skin and parallel to the floor. After measuring each calf twice, an average circumference was recorded. Handgrip strength (HGS) was assessed by conducting three measurements on each hand using a Smedley-type dynamometer (EH101; CAMRY, Guangdong, China). Patients were instructed to stand with their elbows fully extended and to exert a maximum-effort isometric contraction while squeezing the dynamometer. The highest reading obtained from three measurements on each hand was recorded, and the maximum value from either hand was utilized for analysis. Appendicular skeletal muscle mass (ASM) was measured using a bioelectrical impedance analysis (BIA) device (Inbody H20N, InBody Co., Ltd., Seoul, Korea). Participants were instructed to undergo BIA measurements in the morning on an empty stomach to standardize body water distribution, ensuring they emptied their bladder and bowels and refrained from physical activities, showering, sauna use, or any activities affecting body moisture beforehand. Skeletal muscle mass index (SMI) was calculated by dividing ASM by the square of the patient’s height. A short physical performance battery (SPPB) was conducted, and its subtest scores and timings were determined. The SPPB consists of three subsets including static balance, gait speed, and chair sit-to-stand test [ 21 ]. To evaluate static balance, patients were instructed to maintain three standing postures of increasing difficulty, feet-together, semi-tandem, and full-tandem stance, for up to 10 s each. Patients were timed until movement or until 10 s had elapsed. For the gait speed test, patients walked at their comfortable pace across a 4-meter distance, and the average time for two trials was recorded. To assess chair sit-to-stand time, patients crossed their arms over their chests and, as quickly as possible, performed five stands from a standard chair. The time taken to complete the five sit-to-stand tasks was recorded. Each of the three subtests was scored on a scale from 0 to 4; the total score, ranging from 0 to 12, was the sum of these subtest scores.

Definition of Sarcopenia

In this study, cut-off values recommended by AWGS 2019 were utilized for identifying low calf circumference (males: < 34 cm and females: < 33 cm), low SMI (males: < 7.0 kg/m 2 and females: < 5.7 kg/m 2 ), low HGS (males: < 28 kg and females: < 18 kg), and low SPPB score (total score ≤ 9 for both sexes) [ 1 ]. Calf circumference cut-off values were used for screening or case-finding of sarcopenia. Sarcopenia was defined as cases with both low muscle mass and strength (low SMI + low HGS), irrespective of the SPPB score, and cases with poor physical performance were classified into severe sarcopenia (low SMI + low HGS + low SPPB score) [ 1 ].

Patient demographics and clinical data

Demographic information, pain-related data, and clinical data were extracted from the institutional electronic medical record database system. Patient characteristics encompassed age, sex, and body mass index (BMI). Patient history of diagnosed comorbid conditions and current medications was obtained. Conditions assessed included fall history, cerebro-cardiovascular diseases, diabetes mellitus, osteoporosis, and urinary incontinence. The presence of leg pain (a sciatica symptom), pain duration, and average pain intensity score using a 0 to 10 numeric rating scale (NRS) for the preceding week were identified as pain-related variables.

Statistical analysis

Descriptive statistics were utilized to summarize continuous variables and are presented as mean values along with standard deviations (SD) and ranges. Categorical variables are expressed as counts and percentages. For data not conforming to normal distribution, median values and interquartile ranges (IQR) are reported with the Shapiro-Wilk test normality assessment results. To compare patient characteristics between the non-sarcopenia and sarcopenia groups, various statistical tests were employed. Independent Student’s t-tests compared means for continuous variables with normal distributions, while the Mann–Whitney U test compared medians for continuous variables with non-normal distributions. Chi-squared tests or Fisher’s exact tests were used for categorical variables. To explore the relationship between calf circumference and SMI, HGS, and SPPB score, linear regression analysis was performed with adjustments for age, BMI and comorbidities that showed significant differences between sarcopenia and non-sarcopenia groups. Specifically, calf circumference was adjusted based on BMI categories (< 25 kg/m² [normal], 25–29 kg/m² [overweight], and ≥ 30 kg/m² [obese]), as recommended by Gonzalez et al. [ 22 ], to address potential underestimation in individuals with excess weight who could otherwise show falsely normal calf circumference values. Receiver operating characteristic (ROC) curve analysis was utilized to assess the predictive ability of calf circumference, and corresponding area under the curve (AUC) values and confidence intervals were calculated. Sex-specific calf circumference cut-off values for predicting low SMI, sarcopenia, and severe sarcopenia were determined using ROC analysis and the Youden index. Statistical analyses were conducted using IBM SPSS Statistics, version 25.0 (IBM Corp, Armonk, NY), and statistical significance was set at a p -value less than 0.05.

Within the study period, 988 patients presented with low back pain as their chief complaint at our clinic. After excluding 396 patients based on the study’s exclusion criteria, 592 patients aged 65–90 years (mean age 71.77 ± 6.24 years) were included in the analysis. The sample consisted of 187 males and 405 females. All participants underwent sarcopenia assessment according to the AWGS 2019 criteria, with 507 patients classified as non-sarcopenic and 85 patients (14.3%) classified as sarcopenic (Fig.  1 ). There was a notable difference in the prevalence of sarcopenia between male and female patients; prevalence was 9.0% among males and 16.7% among females ( p  = 0.016). The number of patients diagnosed as having severe sarcopenia was 71 out of 592 patients (11.9%).

Study flowchart. MRI, magnetic resonance imaging; AWGS, Asian Working Group for Sarcopenia

A comparison of patient demographics, comorbid medical conditions, sarcopenia-related measurements, and pain-related data between patients with and without sarcopenia is presented in Table  1 . For both sexes, older patients and patients with lower BMIs were more frequently diagnosed with sarcopenia. In the sarcopenia group, more patients of both sexes had a history of falling. The prevalence of osteoporosis was higher in women with sarcopenia than in those without sarcopenia. Smaller calf circumference, lower muscle mass, lower HGS, and lower SPBB scores were observed in the sarcopenia group. Between the two groups in both sexes, there were no significant differences in pain-related variables. Also, after adjusting for age, BMI, and comorbidities, calf circumference showed a positive correlation with SMI but not with HGS and SPPB score in both male and female patients (Table  2 ).

The results of ROC analysis for predicting low muscle mass and sarcopenia using calf circumference values are illustrated in Fig.  2 . The AUC values for low SMI and sarcopenia were 0.776 (95% CI = 0.698–0.854, p  < 0.001) and 0.754 (95% CI = 0.636–0.871, p  = 0.001), respectively, in males, and 0.717 (95% CI = 0.663–0.771, p  < 0.001) and 0.721 (95% CI = 0.657–0.786, p  < 0.001), respectively, in females. The cut-off values of calf circumference for predicting low SMI and sarcopenia were 34 cm (sensitivity 71.8%, specificity 68.4%) and 34 cm (sensitivity 67.1%, specificity 70.6%), respectively, in males, and 32 cm (sensitivity 74.9%, specificity 57.1%) and 31 cm (sensitivity 82.5%, specificity 51.5%) respectively, in females. When applying the AWGS 2019 cut-off of calf circumference, < 33 cm, for predicting sarcopenia in female patients, sensitivity and specificity were 57.3% and 75.0%, respectively.

Receiver operating characteristic curves for calf circumference in predicting low muscle mass and sarcopenia. Receiver operating characteristic curves for calf circumference in the prediction of low muscle mass (solid line) and sarcopenia (dotted line) in males (A) and females (B) The area under the curve values with 95% confidence intervals for low muscle mass and sarcopenia were 0.776 (0.698–0.854) and 0.754 (0.636–0.871), respectively in males, and 0.717 (0.663–0.771) and 0.721 (0.657–0.786), respectively, in females

In this study, we observed that calf circumference cut-off values for predicting low muscle mass and sarcopenia were determined to be 34 cm in males, while in females, these values were 32 cm and 31 cm, respectively, which diverged from the AWGS 2019 recommendations. Furthermore, our findings indicated a significant positive correlation between calf circumference and muscle mass, though no such association was observed with muscle strength and physical performance measures.

Previously reported cut-offs for calf circumference were 32 to 34 cm in men and 32 to 33 cm in women among the older Asian population [ 8 , 9 , 10 , 11 , 12 ]. These values were developed in consideration of the increase in sensitivity and were consistent with AWGS 2019 recommendations of < 34 cm for men and < 33 cm for women during sarcopenia screening or case-finding [ 1 ]. The AUC value of calf circumference cut-offs suggested by AWGS 2019 for predicting sarcopenia (defined by low SMI and low HGS) was 0.647 in 2123 adults aged 70 to 84 years [ 11 ]. In 657 adults with mean age of 76.2 years, the AUC values of calf circumference for predicting sarcopenia met AWGS 2019 criteria, 0.82 for men and 0.72 for women [ 12 ]. Thus, the predictive performance of calf circumference for sarcopenia in the study population, AUC = 0.754 in males and AUC = 0.721 in females, was similar to previous results from the older population data according to AWGS 2019 criteria. These data are clinically acceptable; however, the predictive power of calf circumference for muscle mass and sarcopenia was lower in women than in men in this study. This observation was consistent with previous results [ 7 , 12 ]. As higher fat mass in the legs is generally observed in women compared to men [ 23 ], this factor could potentially affect the predictive power of calf circumference regarding muscle mass and sarcopenia in female patients in this study.

The pattern of changes in calf circumference in patients with symptomatic degenerative lumbar spinal disease has not been widely studied. Peripheral nerves originating from the lumbar spinal nerves are distributed to the muscles of the lower limbs. In this anatomical context, muscle denervation as the result of neural compression following degenerative change of lumbar spine structures causes a reduction in muscle size in the affected area of the lower limbs [ 24 ]. In older patients with CLBP, leg pain and neurogenic claudication can precipitate a detrimental cycle in which reduced physical activity contributes to muscle atrophy and exacerbates deconditioning and disability [ 25 ]. Furthermore, electromyographical evidence suggests that reinnervation of muscle fibers in the older population with sarcopenia to compensate for the loss of innervating motor neurons and denervation of muscle fibers was observed significantly less frequently than in healthy controls [ 26 ]. These potential changes of calf circumference in our study population might affect relatively lower sensitivity values of calf circumference for identifying low muscle mass and sarcopenia when compared with those from general older papulation data [ 12 ].

Also, the clinical features discussed occur more among women with CLBP than among men; in addition, among patients with degenerative lumbar spinal disease, female patients have higher pain scores and more frequent functional impairment and lower quality of life than male patients [ 27 ]. In this study, the prevalence of sarcopenia was almost twice as high in female patients compared to male patients. The difference in the prevalence of sarcopenia between sexes varies depending on which guidelines are applied. In recent European and Asian guideline reports, sarcopenia was more prevalent in men than in women [ 11 , 28 ]. Although the causal relationship between sarcopenia and pain cannot be determined from this study, female patients seem to be more vulnerable to the risk of sarcopenia in chronic pain conditions.

Our results showed that the proposed AWGS 2019 calf circumference cut-off values were valid for predicting sarcopenia in male patients with CLBP. However, in female CLBP patients, the sensitivity of calf circumference for predicting sarcopenia was 82.5% when applying a cut-off of < 31 cm; however, when applying the AWGS 2019 recommended value of < 33 cm, a 30% reduction in sensitivity resulted. Therefore, when using calf circumference as a case-finding marker for sarcopenia among patients with CLBP, sex difference in predictive value for sarcopenia should be considered.

Notably, severe sarcopenia was more prevalent in the study population than in the general older population. In a previous study using AWGS 2019 criteria, the prevalence of severe sarcopenia was 3.3% [ 11 ], but our prevalence was 11.9%, almost four times higher. In this study, physical performance was measured using SPPB, a tool designed to evaluate lower limb function encompassing balance, strength, and mobility [ 21 ]. We found that the presence or absence of sarcopenia did not correlate with differences in reported pain levels or pain-related characteristics among our study participants. However, it is important to note that patients with CLBP often experience leg or foot pain and may exhibit difficulties in walking, which could adversely impact their SPPB scores. This suggests that while sarcopenia may not directly correlate with reported pain levels, the functional implications of CLBP are significant considerations in this patient population.

Anthropometric measurements do not reflect body composition including intramuscular and subcutaneous fat. Therefore, calf circumference does not fully reflect muscle quality which is closely related to muscle strength and physical function [ 29 ]. Indeed, calf circumference did not significantly correlate with muscle strength and physical performance in this study, which contrasts with the results from the general older population [ 12 ]. Recent research has indicated that age-related declines in skeletal muscle strength, muscle mass, and muscle quality vary between the upper limbs and lower limbs, leading to potential differences in clinical interpretations for diagnosing sarcopenia [ 30 , 31 ]. Therefore, when diagnosing sarcopenia and evaluating the severity of sarcopenia for this population, it is crucial to employ a multidimensional assessment approach that considers not only anthropometric measurements and functional assessments but also integrates the clinical characteristics of the chronic pain condition and specific muscle group impairments.

This study has some limitations. The study was conducted at a single tertiary care hospital and included patients of a homogeneous racial and ethnic background, potentially limiting the generalizability of our results to other clinical settings and populations. Our study specifically included patients with confirmed degenerative lumbar spinal diseases identified through radiological evaluation, excluding those with idiopathic low back pain, which is the most prevalent type. This selection criterion may restrict the external validity of our findings. The sample size, particularly for male participants, was small. This not only increases the possibility of sample bias but also limits the statistical power to detect differences and associations accurately within the study cohort. This retrospective analysis only included patients with complete clinical data; the presence of selection biases in the findings cannot be entirely ruled out. The ROC curve can be influenced by class imbalance, where the number of non-sarcopenic cases outweighs the number of sarcopenic cases. This imbalance can lead to misleading optimism about the diagnostic performance of calf circumference as a predictor for sarcopenia. As this study adopts a cross-sectional design, a causal relationship between calf circumference and sarcopenia could not be established. Consequently, longitudinal studies are necessary to validate our findings and elucidate any potential causal associations. BIA is not considered the gold standard for body composition measurement. Also, we did not exclude patients taking diuretic and corticosteroid medications from the analyses, which could affect body water distribution and potentially influence BIA results. However, BIA measurements with multifrequency devices have shown closer correlation with ASM measured by dual-energy X-ray absorptiometry and its adequate performance across multiple domains [ 32 ]. Additionally, while there is no worldwide consensus on the exact list of geriatric syndromes, we collected data on several important factors leading to geriatric syndromes, including falls, urinary incontinence, functional decline, and sarcopenia. Although polypharmacy was not explicitly investigated, the comorbidities we examined are based on current medication diagnoses and thus reflect drug administration to some extent. Specific malnutrition and cognitive impairment statuses were not measured with dedicated tools for each individual; however, we excluded patients who were non-ambulatory or unable to complete the sarcopenia assessment due to severe cognitive impairment. Future studies should include a broader range of factors to provide a more comprehensive assessment and to better inform clinical interventions.

In conclusion, calf circumference appears to be a proxy marker for muscle mass estimated by BIA measurements and may serve as a potential case-finding marker for sarcopenia in older patients with CLBP. Also, although the predictive characteristics differed between the sexes, the predictive performance of calf circumference for sarcopenia in the study population was similar to the results from the older, community-dwelling population data. Therefore, our results suggest that calf circumference is a clinical indicator for predicting muscle mass and may serve as a case-finding marker for sarcopenia in older patients with CLBP.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank C.H. Hwang, BS, for helping with the data analysis for this study.

This work was supported by the National Research Foundation Korea grant funded by the Korea government (No.RS-2023-00245723).

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HJK: literature review, data collection, data analysis, manuscript writing, and manuscript editing, JYK: literature review and data collection, SHK: conceptualization, study design, data analysis, manuscript writing, and manuscript editing. All authors approved the final manuscript.

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Kim, H., Kim, J. & Kim, S. Performance of calf circumference in identifying sarcopenia in older patients with chronic low back pain: a retrospective cross-sectional study. BMC Geriatr 24 , 674 (2024). https://doi.org/10.1186/s12877-024-05263-z

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DOI : https://doi.org/10.1186/s12877-024-05263-z

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