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Case-Control Study: 
A Basic Overview 
Terry Shaneyfelt, MD, MPH 
Associate Professor of Medicine 
Department of Medicine 
ebmteacher.com
Overview of Study Designs
Primary Research
Case-Control: Strengths & 
Weaknesses 
Strengths Weaknesses 
• Good for diseases with long 
latency 
• Good for rare diseases 
• Can determine multiple 
exposures 
• Faster results 
• Can’t establish estimate of risk 
directly nor determine 
prevalence 
• Can only study one disease 
• More prone to bias

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Overview of case control study design

  • 1. Case-Control Study: A Basic Overview Terry Shaneyfelt, MD, MPH Associate Professor of Medicine Department of Medicine ebmteacher.com
  • 4.
  • 5. Case-Control: Strengths & Weaknesses Strengths Weaknesses • Good for diseases with long latency • Good for rare diseases • Can determine multiple exposures • Faster results • Can’t establish estimate of risk directly nor determine prevalence • Can only study one disease • More prone to bias

Editor's Notes

  1. This shows the overall taxonomy of study designs. Studies can be either descriptive or analytic. Descriptive studies are surveys and qualitative. Analytic studies try to examine relationships of cause and outcome. Analytic studies can be experimental where the researcher randomizes patients to get an intervention or a control treatment and then outcomes are measured between the 2 arms. In observational studies the researcher just observes what naturally happens to patients who are exposed to a variety of things.
  2. The primary research is further broken down into the 5 study designs depicted on the right. There is a further hierarchy here with RCTs (randomized controlled trials) being at the top followed by cohort studies, case control studies, cross sectional studies, finally at the bottom case reports/case series. The reason the primary studies are organized in a hierarchy is because different study designs have different potential for bias (or systematic errors in study design). The least prone to bias is the randomized controlled trial. Cohort studies are less prone to bias than case-control studies but more prone to bias than RCTs.
  3. Case-control studies are another type of observational study. In this study design we start with diseased (cases) and non-diseased (controls) patients and go backwards in time (they are retrospective) to figure out their exposures. Case-control studies are more prone to bias (systematic errors). The measure of association in case-control studies is the odds ratio.