Single case studies are individual observations of people who has had the disease
they suffer from independently studied.
Disease symptoms in every individual sufferer are so variable, that is the range,
the cause, the effect etc, prompted us to organise a number of single case studies
that may provide some understanding.
Because the course of disease is unpredictable our experiences over many years demonstrated
to us that generally a sufferer would require an individually prepared plan that
would enable them to combat the effects caused by the disease progression.
From these studies we have slowly drawn together a series of guidelines for the sufferer.
As with any disease progression the benefits any individual may expect is as varied
as their symptoms.
Combating disease is not just a matter of providing and administering a therapy,
it is a matter of lifestyle as well.
About Case Studies
Case studies are individual stories told by the individual sufferer to provide an
insight into what they have experienced since being diagnosed with a disease.
People who suffer from any disease have a story to tell which provides an insight
into their personal experiences:
What steps they have taken to combat the problems they face.
What difficulties they have to confront.
How it has affected them and their loved ones.
How they have been treated by health professionals.
What therapies they have tried and what benefit it provided, if any.
Any information they may like to share.
Most importantly it enables them to have a voice.
If you have a case study story to tell about your experiences combating disease and
would like to share it with others contact us and we will post it on our web site.
Your story can be about treatments, whether good or bad. It can be about any personal
experience, good or bad that you may have had with health professionals, social workers,
health charities or any other third parties.
Wellness and rehabilitation studies play an important role in combating disease and
is as important as any available therapies offered or prescribed for you. This is
a matter of in-depth discussion with health professionals. Therefore ensure that
those you confer with are open to discussion and have the necessary information,
knowledge and experience in all fields.
As Dr David Price Phd - clarified in his article about research methods, Drugs and
Safety, although the randomised controlled trial is considered by the medical profession
as the ‘gold standard’ in drug trials, it does have its limitations, not least in
the numbers needed to prove the effectiveness and safety of the drug or intervention.
There are other methods, not looked upon as favourably by the research communities,
but which do have certain advantages and are gradually gaining acceptance. One such
approach is what is known as the single case study or small-n research (n= number
of subjects). It is important to differentiate what is meant by a case study and
a single case study or experiment.
Case studies are usually retrospective reports made on observations of a particular
patient. In fact many are effectively writing their own case studies in the daily
or weekly diaries they keep on the effects of the medication administered and the
personal efforts made to combat symptoms created by the disease they suffer. By noting
the changes that occur these are always valuable records and may hold clues for future
clinical evaluations and the detailed observations that accrue can be used to develop
a pool of empirical evidence.
A single case study or experiment is somewhat different. The researcher is looking
at an individual and the effect the intervention has on a number of variables – signs
and symptoms – so that any changes that occur can be recorded accurately. It can
be seen that a number of well -recorded and objective single case studies could collectively
provide useful baseline data for the evaluation of a treatment .
As the results of the single case study focus on the individual rather than the average
person, in-depth data from a number of individuals may be more reliable than that
from a larger group studied superficially. Both quantitative and qualitative methods
can be used to generate data that can be analysed in a number of ways. Quantitative
data would involve repeated measurements of defined variables in a single person
over time– for example the range of active movement in a stiff joint, the severity
of spasticity, or frequency of incontinence.
A problem with this approach is associated with obtaining repeated accurate measurements
of variables such as pain, spasticity, frequency of incontinence or functional activities.
So it is essential that comprehensive baseline data be collected before the treatment
begins. Ideally this would mean a full physical assessment by a specialist practitioner
in the appropriate discipline (For MS for example, a neurologist or a neuro-physiotherapist)
followed by regular reassessments.
There is still value in the qualitative recording of more subjective data through
questionnaires and semi-structured interviews. The information gained from the reported
experiences, attitudes and judgements of the individual subjects provides rich data
that can be subsequently analysed to find key words and common themes that the investigator
use to generate theories that might be more widely generalisable.
Those who are unfortunate to be affected by a disease should consider ourselves suitable
research subjects and make sure that they keep accurate diaries recording every change
that occurs whilst on a treatment programmes. Many have developed their own way of
recording changes so that the diary is easy to keep, accurate and informative to
another reader.
If you have examples of such record-keeping methods or have your personal single
case study that you would like to share, please contact us. Together perhaps we can
assemble a record-keeping format that everyone could use that would be of value to
researchers.
Author - Gillian Jordon
Background - Gillian Jordan has an inflammatory condition known as Adhesive Arachnoiditis,
as well as Syringomyelia. This results in a range of unpleasant symptoms, probably
familiar to many of you with similar conditions. They include severe pain in both
legs, flexor and adductor spasticity, increasing leg weakness, numbness in both feet,
bladder and bowel dysfunction and episodes of profound and unpleasant sweating.
