1. Introduction to case study methodology
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Training of Trainers in Epidemiology of Vaccine Preventable Diseases
Introduction to case study methodology
Created in February 2012, revised May 2018

2. Objectives Specific objectives of this session:
To understand the concept of the case study teaching method;
To develop new case studies, using some tips provided.
Related to the course objectives:
A. Familiarity with interactive and adult learning methods, e.g. case studies;
B. Ability to facilitate case studies in these areas;
C. Ability to define the target audience and to adjust material/contents
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3. Outline This session consists of the following elements
Definition and types of case studies
Examples of existing case studies
How to develop a case study ?
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4. Definition and types of case studies

5. Definintion of term ”Case Study”
Complex examples which give an insight into the context of a problem as well as illustrating the main point (Fry 1999).
Student centred activities based on topics that demonstrate theoretical concepts in an applied setting.
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6. History of the Case study methodology
It is generally believed that the case-study method was first introduced into social science by Frederic Le Play in 1829 as a handmaiden to statistics in his studies of family budgets. (Les Ouvriers Europeens; 2nd edition, 1879).
The use of case studies for the creation of new theory in social sciences has been further developed by the sociologists Barney Glaser and Anselm Strauss who presented their research method, Grounded theory, in 1967.
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7. … history of case study methodology
The popularity of case studies in testing hypotheses has developed only in recent decades.
One of the areas in which case studies have been gaining popularity is education and in particular educational evaluation.
Case studies have been used as a teaching method and as part of professional development, especially in business and legal education.
The problem-based learning (PBL) movement is such an example.
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8. The continuum of case studies
A simple problem scenario (PBL)
A full blown description of a case of VPD outbreak with control activities and upgrading of systems thereafter with many methodological teaching points
Structured with a pre written manuscript, ”right answers”
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9. Example of a simple case study (PBL)
A foreign student from Uganda, now living in Tampere Finland, has been coughing and having low grade fever for the past 3 weeks.
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10. Structured Infectious Disease Epidemiology case studies
IDE case study is a document that illustrates a real life outbreak, vaccine safety problem, VPD surveillance or policy situation to be solved and includes background and methodology information for classroom discussion.
The situation does not always have an obvious solution. The case provides information to stimulate an educated conversation concerning possible outcomes.
Each case has at least one central decision point, dilemma, or angle.
The nature of the situation is introduced within the first paragraphs.
The writing in a case is precise and nuanced, yet always clear and concise. It is neither colloquial nor stuffily formal. It is engaging and interesting to the reader.
It is imperative for a case writer to always be factual and objective - a case is not a marketing or opinion pamphlet, though the writer may portray biases that the different stakeholders and protagonist may have.
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11. Examples of existing case studies

12. The U.S. Center for Disease Control Epidemiology Intelligence System case studies
Measles in Burundi (from early 1980´s )
Hepatitis A outbreak in the U.S.
Participants version with scenario and questions
Facilitators version with sample answers and reminder list of issues to be discussed
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13. Since 1995, EPIET has developed vaccines related case studies
Acellular pertussis trials – study design comparisons to understand VE estimates
Polio in Albania
Measles in UK
Rotavirus – a new vaccine for Europe?
Mumps in Moldova
Measles in Ukraine
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14. Case studies used in the Advanced Course in Vaccinology since 12 years
How to design a phase II trial
PCV clinical trials – critical appraisal and CONSORT
Ethical issues in vaccine trials (HIV, malaria)
Post introduction surveillance for measuring vaccine programme impact (VPD, safety)
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15. CONSORT: 3 randomised clinical trials on Pneumococcal conjugate vaccines
South Africa – PCV9, individual randomized CT, HIV+/-
The Gambia – PCV9, individual randomized CT
Navajo, US – PCV7, cluster randomized CT
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16. How to develop a case study ?

17. How do you develop a case study ?
Developing a case study based on the research interests of staff
Requesting students to develop case studies based on personal interests
Develop from scratch, maybe following interests/ideas picked up from elsewhere
Invite external lecturers to develop, or contribute to, a case study
Developing a case study to replace more traditional teaching on the same topic
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18. Sources of case study in VPD epidemiology
Questions you have answered in phone as part of your / your staff´s daily duties
Clinico-epidemiological problems that have come to your attention / you have solved in your work
Published scientific reports
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19. New country specific case studies, and ideas for case studies
HPV introduction in the Netherlands (since 2010-)
Narcolepsy in Finland (to be developed)
YOUR case study to be developed after this course to serve your country purposes !
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20. Facilitator notes:
Acknowledgements The creation of this training material was commissioned in 2012 by ECDC to the consortium of experts with the direct involvement of Hana Nohynek. The revision and update of this training material was commissioned in 2017 by ECDC to Transmissible with the direct involvement of Pawel Stefanoff and Arnold Bosman