data analysis of case study

• Privacy Policy

Buy Me a Coffee

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

You may also like

Questionnaire – Definition, Types, and Examples

Observational Research – Methods and Guide

Quantitative Research – Methods, Types and...

Qualitative Research Methods

Explanatory Research – Types, Methods, Guide

Survey Research – Types, Methods, Examples

Qualitative case study data analysis: an example from practice

Affiliation.

• 1 School of Nursing and Midwifery, National University of Ireland, Galway, Republic of Ireland.
• PMID: 25976531
• DOI: 10.7748/nr.22.5.8.e1307

Aim: To illustrate an approach to data analysis in qualitative case study methodology.

Background: There is often little detail in case study research about how data were analysed. However, it is important that comprehensive analysis procedures are used because there are often large sets of data from multiple sources of evidence. Furthermore, the ability to describe in detail how the analysis was conducted ensures rigour in reporting qualitative research.

Data sources: The research example used is a multiple case study that explored the role of the clinical skills laboratory in preparing students for the real world of practice. Data analysis was conducted using a framework guided by the four stages of analysis outlined by Morse ( 1994 ): comprehending, synthesising, theorising and recontextualising. The specific strategies for analysis in these stages centred on the work of Miles and Huberman ( 1994 ), which has been successfully used in case study research. The data were managed using NVivo software.

Review methods: Literature examining qualitative data analysis was reviewed and strategies illustrated by the case study example provided. Discussion Each stage of the analysis framework is described with illustration from the research example for the purpose of highlighting the benefits of a systematic approach to handling large data sets from multiple sources.

Conclusion: By providing an example of how each stage of the analysis was conducted, it is hoped that researchers will be able to consider the benefits of such an approach to their own case study analysis.

Implications for research/practice: This paper illustrates specific strategies that can be employed when conducting data analysis in case study research and other qualitative research designs.

Keywords: Case study data analysis; case study research methodology; clinical skills research; qualitative case study methodology; qualitative data analysis; qualitative research.

• Case-Control Studies*
• Data Interpretation, Statistical*
• Nursing Research / methods*
• Qualitative Research*
• Research Design

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, generate accurate citations for free.

• Knowledge Base

Methodology

• What Is a Case Study? | Definition, Examples & Methods

What Is a Case Study? | Definition, Examples & Methods

Published on May 8, 2019 by Shona McCombes . Revised on November 20, 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organization, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyze the case, other interesting articles.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

Prevent plagiarism. Run a free check.

Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

TipIf your research is more practical in nature and aims to simultaneously investigate an issue as you solve it, consider conducting action research instead.

Unlike quantitative or experimental research , a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

Example of an outlying case studyIn the 1960s the town of Roseto, Pennsylvania was discovered to have extremely low rates of heart disease compared to the US average. It became an important case study for understanding previously neglected causes of heart disease.

However, you can also choose a more common or representative case to exemplify a particular category, experience or phenomenon.

Example of a representative case studyIn the 1920s, two sociologists used Muncie, Indiana as a case study of a typical American city that supposedly exemplified the changing culture of the US at the time.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews , observations , and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data.

Example of a mixed methods case studyFor a case study of a wind farm development in a rural area, you could collect quantitative data on employment rates and business revenue, collect qualitative data on local people’s perceptions and experiences, and analyze local and national media coverage of the development.

The aim is to gain as thorough an understanding as possible of the case and its context.

Receive feedback on language, structure, and formatting

Professional editors proofread and edit your paper by focusing on:

• Academic style
• Vague sentences
• Style consistency

See an example

In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis , with separate sections or chapters for the methods , results and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyze its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

• Normal distribution
• Degrees of freedom
• Null hypothesis
• Discourse analysis
• Control groups
• Mixed methods research
• Non-probability sampling
• Quantitative research
• Ecological validity

Research bias

• Rosenthal effect
• Implicit bias
• Cognitive bias
• Selection bias
• Negativity bias
• Status quo bias

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

McCombes, S. (2023, November 20). What Is a Case Study? | Definition, Examples & Methods. Scribbr. Retrieved April 9, 2024, from https://www.scribbr.com/methodology/case-study/

Is this article helpful?

Shona McCombes

Other students also liked, primary vs. secondary sources | difference & examples, what is a theoretical framework | guide to organizing, what is action research | definition & examples, what is your plagiarism score.

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, automatically generate references for free.

• Knowledge Base
• Methodology
• Case Study | Definition, Examples & Methods

Case Study | Definition, Examples & Methods

Published on 5 May 2022 by Shona McCombes . Revised on 30 January 2023.

A case study is a detailed study of a specific subject, such as a person, group, place, event, organisation, or phenomenon. Case studies are commonly used in social, educational, clinical, and business research.

A case study research design usually involves qualitative methods , but quantitative methods are sometimes also used. Case studies are good for describing , comparing, evaluating, and understanding different aspects of a research problem .

Table of contents

When to do a case study, step 1: select a case, step 2: build a theoretical framework, step 3: collect your data, step 4: describe and analyse the case.

A case study is an appropriate research design when you want to gain concrete, contextual, in-depth knowledge about a specific real-world subject. It allows you to explore the key characteristics, meanings, and implications of the case.

Case studies are often a good choice in a thesis or dissertation . They keep your project focused and manageable when you don’t have the time or resources to do large-scale research.

You might use just one complex case study where you explore a single subject in depth, or conduct multiple case studies to compare and illuminate different aspects of your research problem.

Prevent plagiarism, run a free check.

Once you have developed your problem statement and research questions , you should be ready to choose the specific case that you want to focus on. A good case study should have the potential to:

• Provide new or unexpected insights into the subject
• Challenge or complicate existing assumptions and theories
• Propose practical courses of action to resolve a problem
• Open up new directions for future research

Unlike quantitative or experimental research, a strong case study does not require a random or representative sample. In fact, case studies often deliberately focus on unusual, neglected, or outlying cases which may shed new light on the research problem.

If you find yourself aiming to simultaneously investigate and solve an issue, consider conducting action research . As its name suggests, action research conducts research and takes action at the same time, and is highly iterative and flexible. 

However, you can also choose a more common or representative case to exemplify a particular category, experience, or phenomenon.

While case studies focus more on concrete details than general theories, they should usually have some connection with theory in the field. This way the case study is not just an isolated description, but is integrated into existing knowledge about the topic. It might aim to:

• Exemplify a theory by showing how it explains the case under investigation
• Expand on a theory by uncovering new concepts and ideas that need to be incorporated
• Challenge a theory by exploring an outlier case that doesn’t fit with established assumptions

To ensure that your analysis of the case has a solid academic grounding, you should conduct a literature review of sources related to the topic and develop a theoretical framework . This means identifying key concepts and theories to guide your analysis and interpretation.

There are many different research methods you can use to collect data on your subject. Case studies tend to focus on qualitative data using methods such as interviews, observations, and analysis of primary and secondary sources (e.g., newspaper articles, photographs, official records). Sometimes a case study will also collect quantitative data .

The aim is to gain as thorough an understanding as possible of the case and its context.

In writing up the case study, you need to bring together all the relevant aspects to give as complete a picture as possible of the subject.

How you report your findings depends on the type of research you are doing. Some case studies are structured like a standard scientific paper or thesis, with separate sections or chapters for the methods , results , and discussion .

Others are written in a more narrative style, aiming to explore the case from various angles and analyse its meanings and implications (for example, by using textual analysis or discourse analysis ).

In all cases, though, make sure to give contextual details about the case, connect it back to the literature and theory, and discuss how it fits into wider patterns or debates.

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the ‘Cite this Scribbr article’ button to automatically add the citation to our free Reference Generator.

McCombes, S. (2023, January 30). Case Study | Definition, Examples & Methods. Scribbr. Retrieved 9 April 2024, from https://www.scribbr.co.uk/research-methods/case-studies/

Is this article helpful?

Shona McCombes

Other students also liked, correlational research | guide, design & examples, a quick guide to experimental design | 5 steps & examples, descriptive research design | definition, methods & examples.

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Ann Indian Acad Neurol
• v.16(4); Oct-Dec 2013

Design and data analysis case-controlled study in clinical research

Sanjeev v. thomas.

Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India

Karthik Suresh

1 Department of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Louiseville, USA

Geetha Suresh

2 Department of Justice Administration, University of Louisville, Louiseville, USA

Clinicians during their training period and practice are often called upon to conduct studies to explore the association between certain exposures and disease states or interventions and outcomes. More often they need to interpret the results of research data published in the medical literature. Case-control studies are one of the most frequently used study designs for these purposes. This paper explains basic features of case control studies, rationality behind applying case control design with appropriate examples and limitations of this design. Analysis of sensitivity and specificity along with template to calculate various ratios are explained with user friendly tables and calculations in this article. The interpretation of some of the laboratory results requires sound knowledge of the various risk ratios and positive or negative predictive values for correct identification for unbiased analysis. A major advantage of case-control study is that they are small and retrospective and so they are economical than cohort studies and randomized controlled trials.

Introduction

Clinicians think of case-control study when they want to ascertain association between one clinical condition and an exposure or when a researcher wants to compare patients with disease exposed to the risk factors to non-exposed control group. In other words, case-control study compares subjects who have disease or outcome (cases) with subjects who do not have the disease or outcome (controls). Historically, case control studies came into fashion in the early 20 th century, when great interest arose in the role of environmental factors (such as pipe smoke) in the pathogenesis of disease. In the 1950s, case control studies were used to link cigarette smoke and lung cancer. Case-control studies look back in time to compare “what happened” in each group to determine the relationship between the risk factor and disease. The case-control study has important advantages, including cost and ease of deployment. However, it is important to note that a positive relationship between exposure and disease does not imply causality.

At the center of the case-control study is a collection of cases. [ Figure 1 ] This explains why this type of study is often used to study rare diseases, where the prevalence of the disease may not be high enough to permit for a cohort study. A cohort study identifies patients with and without an exposure and then “looks forward” to see whether or not greater numbers of patients with an exposure develop disease.

Comparison of cohort and case control studies

For instance, Yang et al . studied antiepileptic drug (AED) associated rashes in Asians in a case-control study.[ 1 ] They collected cases of confirmed anti-epileptic induced severe cutaneous reactions (such as Stevens Johnson syndrome) and then, using appropriate controls, analyzed various exposures (including type of [AED] used) to look for risk factors to developing AED induced skin disease.

Choosing controls is very important aspect of case-control study design. The investigator must weigh the need for the controls to be relevant against the tendency to over match controls such that potential differences may become muted. In general, one may consider three populations: Cases, the relevant control population and the population at large. For the study above, the cases include patients with AED skin disease. In this case, the relevant control population is a group of Asian patients without skin disease. It is important for controls to be relevant: In the anti-epileptic study, it would not be appropriate to choose a population across ethnicities since one of the premises of the paper revolves around particularly susceptibility to AED drug rashes in Asian populations.

One popular method of choosing controls is to choose patients from a geographic population at large. In studying the relationship between non-steroidal anti-inflammatory drugs and Parkinson's disease (PD), Wahner et al . chose a control population from several rural California counties.[ 2 ] There are other methods of choosing controls (using patients without disease admitted to the hospital during the time of study, neighbors of disease positive cases, using mail routes to identify disease negative cases). However, one must be careful not to introduce bias into control selection. For instance, a study that enrolls cases from a clinic population should not use a hospital population as control. Studies looking at geography specific population (e.g., Neurocysticercosis in India) cannot use controls from large studies done in other populations (registries of patients from countries where disease prevalence may be drastically different than in India). In general, geographic clustering is probably the easiest way to choose controls for case-control studies.

Two popular ways of choosing controls include hospitalized patients and patients from the general population. Choosing hospitalized, disease negative patients offers several advantages, including good rates of response (patients admitted to the hospital are generally already being examined and evaluated and often tend to be available to further questioning for a study, compared with the general population, where rates of response may be much lower) and possibly less amnestic bias (patients who are already in the hospital are, by default, being asked to remember details of their presenting illnesses and as such, may more reliably remember details of exposures). However, using hospitalized patients has one large disadvantage; these patients have higher severity of disease since they required hospitalization in the first place. In addition, patients may be hospitalized for disease processes that may share features with diseases under study, thus confounding results.

Using a general population offers the advantage of being a true control group, random in its choosing and without any common features that may confound associations. However, disadvantages include poor response rates and biasing based on geography. Administering long histories and questions regarding exposures are often hard to accomplish in the general population due to the number of people willing (or rather, not willing) to undergo testing. In addition, choosing cases from the general population from particular geographic areas may bias the population toward certain characteristics (such as a socio-economic status) of that geographic population. Consider a study that uses cases from a referral clinic population that draws patients from across socio-economic strata. Using a control group selected from a population from a very affluent or very impoverished area may be problematic unless the socio-economic status is included in the final analysis.

In case-controls studies, cases are usually available before controls. When studying specific diseases, cases are often collected from specialty clinics that see large numbers of patients with a specific disease. Consider for example, the study by Garwood et al .[ 3 ] which looked at patients with established PD and looked for associations between prior amphetamine use and subsequent development various neurologic disorders. Patients in this study were chosen from specialty clinics that see large numbers of patients with certain neurologic disorders. Case definitions are very important when planning to choose cases. For instance, in a hypothetical study aiming to study cases of peripheral neuropathy, will all patients who carry a diagnosis of peripheral neuropathy be included? Or, will only patients with definite electromyography evidence of neuropathy be included? If a disease process with known histopathology is being studied, will tissue diagnosis be required for all cases? More stringent case definitions that require multiple pieces of data to be present may limit the number of cases that can be used in the study. Less stringent criteria (for instance, counting all patients with the diagnosis of “peripheral neuropathy” listed in the chart) may inadvertently choose a group of cases that are too heterogeneous.

The disease history status of the chosen cases must also be decided. Will the cases being chosen have newly diagnosed disease, or will cases of ongoing/longstanding disease also be included? Will decedent cases be included? This is important when looking at exposures in the following fashion: Consider exposure X that is associated with disease Y. Suppose that exposure X negatively affects disease Y such that patients that are X + have more severe disease. Now, a case-control study that used only patients with long-standing or ongoing disease might miss a potential association between X and Y because X + patients, due to their more aggressive course of disease, are no longer alive and therefore were not included in the analysis. If this particular confounding effect is of concern, it can be circumvented by using incident cases only.

Selection bias occurs when the exposure of interest results in more careful screening of a population, thus mimicking an association. The classic example of this phenomenon was noted in the 70s, when certain studies noted a relationship between estrogen use and endometrial cancer. However, on close analysis, it was noted that patients who used estrogen were more likely to experience vaginal bleeding, which in turn is often a cause for close examination by physicians to rule out endometrial cancer. This is often seen with certain drug exposures as well. A drug may produce various symptoms, which lead to closer physician evaluation, thus leading to more disease positive cases. Thus, when analyzed in a retrospective fashion, more of the cases may have a particular exposure only insofar as that particular exposure led to evaluations that resulted in a diagnosis, but without any direct association or causality between the exposure and disease.

One advantage of case-control studies is the ability to study multiple exposures and other risk factors within one study. In addition, the “exposure” being studied can be biochemical in nature. Consider the study, which looked at a genetic variant of a kinase enzyme as a risk factor for development of Alzheimer's disease.[ 4 ] Compare this with the study mentioned earlier by Garwood et al .,[ 3 ] where exposure data was collected by surveys and questionnaires. In this study, the authors drew blood work on cases and controls in order to assess their polymorphism status. Indeed, more than one exposure can be assessed in the same study and with planning, a researcher may look at several variables, including biochemical ones, in single case-control study.

Matching is one of three ways (along with exclusion and statistical adjustment) to adjust for differences. Matching attempts to make sure that the control group is sufficiently similar to the cases group, with respects to variables such as age, sex, etc., Cases and controls should not be matched on variables that will be analyzed for possible associations to disease. Not only should exposure variables not be included, but neither should variables that are closely related to these variables. Lastly, overmatching should be avoided. If the control group is too similar to the cases group, the study may fail to detect the difference even if one exists. In addition, adding matching categories increases expense of the study.

One measure of association derived from case control studies are sensitivity and specificity ratios. These measures are important to a researcher, to understand the correct classification. A good understanding of sensitivity and specificity is essential to understand receiver operating characteristic curve and in distinguishing correct classification of positive exposure and disease with negative exposure and no disease. Table 1 explains a hypothetical example and method of calculation of specificity and sensitivity analysis.

Hypothetical example of sensitivity, specificity and predictive values

Interpretation of sensitivity, specificity and predictive values

Sensitivity and specificity are statistical measures of the performance of a two by two classification of cases and controls (sick or healthy) against positives and negatives (exposed or non-exposed).[ 5 ] Sensitivity measures or identifies the proportion of actual positives identified as the percentage of sick people who are correctly identified as sick. Specificity measures or identifies the proportion of negatives identified as the percentage of healthy people who are correctly identified as healthy. Theoretically, optimum prediction aims at 100% sensitivity and specificity with a minimum of margin of error. Table 1 also shows false positive rate, which is referred to as Type I error commonly stated as α “Alpha” is calculated using the following formula: 100 − specificity, which is equal to 100 − 90.80 = 9.20% for Table 1 example. Type 1 error is also known as false positive error is referred to as a false alarm, indicates that a condition is present when it is actually not present. In the above mentioned example, a false positive error indicates the percent falsely identified healthy as sick. The reason why we want Type 1 error to be as minimum as possible is because healthy should not get treatment.

The false negative rate, which is referred to as Type II error commonly stated as β “Beta” is calculated using the following formula: 100 − sensitivity which is equal to 100 − 73.30 = 26.70% for Table 1 example. Type II error is also known as false negative error indicates that a condition is not present when it should have been present. In the above mentioned example, a false negative error indicates percent falsely identified sick as healthy. A Type 1 error unnecessarily treats a healthy, which in turn increases the budget and Type II error would risk the sick, which would act against study objectives. A researcher wants to minimize both errors, which not a simple issue because an effort to decrease one type of error increases the other type of error. The only way to minimize both type of error statistically is by increasing sample size, which may be difficult sometimes not feasible or expensive. If the sample size is too low it lacks precision and it is too large, time and resources will be wasted. Hence, the question is what should be the sample size so that the study has the power to generalize the result obtained from the study. The researcher has to decide whether, the study has enough power to make a judgment of the population from their sample. The researcher has to decide this issue in the process of designing an experiment, how large a sample is needed to enable reliable judgment.

Statistical power is same as sensitivity (73.30%). In this example, large number of false positives and few false negatives indicate the test conducted alone is not the best test to confirm the disease. Higher statistical power increase statistical significance by reducing Type 1 error which increases confidence interval. In other words, larger the power more accurately the study can mirror the behavior of the study population.

The positive predictive values (PPV) or the precision rate is referred to as the proportion of positive test results, which means correct diagnoses. If the test correctly identifies all positive conditions then the PPV would be 100% and negative predictive value (NPV) would be 0. The calculative PPV in Table 1 is 11.8%, which is not large enough to predict cases with test conducted alone. However, the NPV 99.9% indicates the test correctly identifies negative conditions.

Clinical interpretation of a test

In a sample, there are two groups those who have the disease and those who do not have the disease. A test designed to detect that disease can have two results a positive result that states that the disease is present and a negative result that states that the disease is absent. In an ideal situation, we would want the test to be positive for all persons who have the disease and test to be negative for all persons who do not have the disease. Unfortunately, reality is often far from ideal. The clinician who had ordered the test has the result as positive or negative. What conclusion can he or she make about the disease status for his patient? The first step would be to examine the reliability of the test in statistical terms. (1) What is the sensitivity of the test? (2) What is the specificity of the test? The second step is to examine it applicability to his patient. (3) What is the PPV of the test? (4) What is the NPV of the test?

Suppose the test result had come as positive. In this example the test has a sensitivity of 73.3% and specificity of 90.8%. This test is capable of detecting the disease status in 73% of cases only. It has a false positivity of 9.2%. The PPV of the test is 11.8%. In other words, there is a good possibility that the test result is false positive and the person does not have the disease. We need to look at other test results and the clinical situation. Suppose the PPV of this test was close to 80 or 90%, one could conclude that most likely the person has the disease state if the test result is positive.

Suppose the test result had come as negative. The NPV of this test is 99.9%, which means this test gave a negative result in a patient with the disease only very rarely. Hence, there is only 0.1% possibility that the person who tested negative has in fact the disease. Probably no further tests are required unless the clinical suspicion is very high.

It is very important how the clinician interprets the result of a test. The usefulness of a positive result or negative result depends upon the PPV or NPV of the test respectively. A screening test should have high sensitivity and high PPV. A confirmatory test should have high specificity and high NPV.

Case control method is most efficient, for the study of rare diseases and most common diseases. Other measures of association from case control studies are calculation of odds ratio (OR) and risk ratio which is presented in Table 2 .

Different ratio calculation templates with sample calculation

Absolute risk means the probability of an event occurring and are not compared with any other type of risk. Absolute risk is expressed as a ratio or percent. In the example, absolute risk reduction indicates 27.37% decline in risk. Relative risk (RR) on the other hand compares the risk among exposed and non-exposed. In the example provided in Table 2 , the non-exposed control group is 69.93% less likely compared to exposed cases. Reader should keep in mind that RR does not mean increase in risk. This means that while a 100% likely risk among those exposed cases, unexposed control is less likely by 69.93%. RR does not explain actual risk but is expressed as relative increase or decrease in risk of exposed compared to non-exposed.

OR help the researcher to conclude whether the odds of a certain event or outcome are same for two groups. It calculates the odds of a health outcome when exposed compared to non-exposed. In our example an OR of. 207 can be interpreted as the non-exposed group is less likely to experience the event compared to the exposed group. If the OR is greater than 1 (example 1.11) means that the exposed are 1.11 times more likely to be riskier than the non-exposed.

Event rate for cases (E) and controls (C) in biostatistics explains how event ratio is a measure of how often a particular statistical exposure results in occurrence of disease within the experimental group (cases) of an experiment. This value in our example is 11.76%. This value or percent explains the extent of risk to patients exposed, compared with the non-exposed.

The statistical tests that can be used for ascertain an association depends upon the variable characteristics also. If the researcher wants to find the association between two categorical variables (e.g., a positive versus negative test result and disease state expressed as present or absent), Cochran-Armitage test, which is same as Pearson Chi-squared test can be used. When the objective is to find the association between two interval or ratio level (continuous) variables, correlation and regression analysis can be performed. In order to evaluate statistical significant difference between the means of cases and control, a test of group difference can be performed. If the researcher wants to find statically significant difference among means of more than two groups, analysis of variance can be performed. A detailed explanation and how to calculate various statistical tests will be published in later issues. The success of the research directly and indirectly depends on how the following biases or systematic errors, are controlled.

When selecting cases and controls, based on exposed or not-exposed factors, the ability of subjects to recall information on exposure is collected retrospectively and often forms the basis for recall bias. Recall bias is a methodological issue. Problems of recall method are: Limitations in human ability to recall and cases may remember their exposure with more accuracy than the controls. Other possible bias is the selection bias. In case-control studies, the cases and controls are selected from the same inherited characteristics. For instance, cases collected from referral clinics often exposed to selection bias cases. If selection bias is not controlled, the findings of association, most likely may be due to of chance resulting from the study design. Another possible bias is information bias, which arises because of misclassification of the level of exposure or misclassification of disease or other symptoms of outcome itself.

Case control studies are good for studying rare diseases, but they are not generally used to study rare exposures. As Kaelin and Bayona explains[ 6 ] if a researcher want to study the risk of asthma from working in a nuclear submarine shipyard, a case control study may not be a best option because a very small proportion of people with asthma might be exposed. Similarly, case-control studies cannot be the best option to study multiple diseases or conditions because the selection of the control group may not be comparable for multiple disease or conditions selected. The major advantage of case-control study is that they are small and retrospective and so they are economical than cohort studies and randomized controlled trials.

Source of Support: Nil

Conflict of Interest: Nil

Currently taking bookings for January 2024 >>

The Convergence Blog

The convergence - an online community space that's dedicated to empowering operators in the data industry by providing news and education about evergreen strategies, late-breaking data & ai developments, and free or low-cost upskilling resources that you need to thrive as a leader in the data & ai space., data analysis case study: learn from humana’s automated data analysis project.

Lillian Pierson, P.E.

Playback speed:

Got data? Great! Looking for that perfect data analysis case study to help you get started using it? You’re in the right place.

If you’ve ever struggled to decide what to do next with your data projects, to actually find meaning in the data, or even to decide what kind of data to collect, then KEEP READING…

Deep down, you know what needs to happen. You need to initiate and execute a data strategy that really moves the needle for your organization. One that produces seriously awesome business results.

But how you’re in the right place to find out..

As a data strategist who has worked with 10 percent of Fortune 100 companies, today I’m sharing with you a case study that demonstrates just how real businesses are making real wins with data analysis. 

In the post below, we’ll look at:

• A shining data success story;
• What went on ‘under-the-hood’ to support that successful data project; and
• The exact data technologies used by the vendor, to take this project from pure strategy to pure success

If you prefer to watch this information rather than read it, it’s captured in the video below:

Here’s the url too: https://youtu.be/xMwZObIqvLQ

3 Action Items You Need To Take

To actually use the data analysis case study you’re about to get – you need to take 3 main steps. Those are:

• Reflect upon your organization as it is today (I left you some prompts below – to help you get started)
• Review winning data case collections (starting with the one I’m sharing here) and identify 5 that seem the most promising for your organization given it’s current set-up
• Assess your organization AND those 5 winning case collections. Based on that assessment, select the “QUICK WIN” data use case that offers your organization the most bang for it’s buck

Step 1: Reflect Upon Your Organization

Whenever you evaluate data case collections to decide if they’re a good fit for your organization, the first thing you need to do is organize your thoughts with respect to your organization as it is today.

Before moving into the data analysis case study, STOP and ANSWER THE FOLLOWING QUESTIONS – just to remind yourself:

• What is the business vision for our organization?
• What industries do we primarily support?
• What data technologies do we already have up and running, that we could use to generate even more value?
• What team members do we have to support a new data project? And what are their data skillsets like?
• What type of data are we mostly looking to generate value from? Structured? Semi-Structured? Un-structured? Real-time data? Huge data sets? What are our data resources like?

Jot down some notes while you’re here. Then keep them in mind as you read on to find out how one company, Humana, used its data to achieve a 28 percent increase in customer satisfaction. Also include its 63 percent increase in employee engagement! (That’s such a seriously impressive outcome, right?!)

Step 2: Review Data Case Studies

Here we are, already at step 2. It’s time for you to start reviewing data analysis case studies  (starting with the one I’m sharing below). I dentify 5 that seem the most promising for your organization given its current set-up.

Humana’s Automated Data Analysis Case Study

The key thing to note here is that the approach to creating a successful data program varies from industry to industry .

Let’s start with one to demonstrate the kind of value you can glean from these kinds of success stories.

Humana has provided health insurance to Americans for over 50 years. It is a service company focused on fulfilling the needs of its customers. A great deal of Humana’s success as a company rides on customer satisfaction, and the frontline of that battle for customers’ hearts and minds is Humana’s customer service center.

Call centers are hard to get right. A lot of emotions can arise during a customer service call, especially one relating to health and health insurance. Sometimes people are frustrated. At times, they’re upset. Also, there are times the customer service representative becomes aggravated, and the overall tone and progression of the phone call goes downhill. This is of course very bad for customer satisfaction.

Humana wanted to use artificial intelligence to improve customer satisfaction (and thus, customer retention rates & profits per customer).

Humana wanted to find a way to use artificial intelligence to monitor their phone calls and help their agents do a better job connecting with their customers in order to improve customer satisfaction (and thus, customer retention rates & profits per customer ).

In light of their business need, Humana worked with a company called Cogito, which specializes in voice analytics technology.

Cogito offers a piece of AI technology called Cogito Dialogue. It’s been trained to identify certain conversational cues as a way of helping call center representatives and supervisors stay actively engaged in a call with a customer.

The AI listens to cues like the customer’s voice pitch.

If it’s rising, or if the call representative and the customer talk over each other, then the dialogue tool will send out electronic alerts to the agent during the call.

Humana fed the dialogue tool customer service data from 10,000 calls and allowed it to analyze cues such as keywords, interruptions, and pauses, and these cues were then linked with specific outcomes. For example, if the representative is receiving a particular type of cues, they are likely to get a specific customer satisfaction result.

The Outcome

Customers were happier, and customer service representatives were more engaged..

This automated solution for data analysis has now been deployed in 200 Humana call centers and the company plans to roll it out to 100 percent of its centers in the future.

The initiative was so successful, Humana has been able to focus on next steps in its data program. The company now plans to begin predicting the type of calls that are likely to go unresolved, so they can send those calls over to management before they become frustrating to the customer and customer service representative alike.

What does this mean for you and your business?

Well, if you’re looking for new ways to generate value by improving the quantity and quality of the decision support that you’re providing to your customer service personnel, then this may be a perfect example of how you can do so.

Humana’s Business Use Cases

Humana’s data analysis case study includes two key business use cases:

• Analyzing customer sentiment; and
• Suggesting actions to customer service representatives.

Analyzing Customer Sentiment

First things first, before you go ahead and collect data, you need to ask yourself who and what is involved in making things happen within the business.

In the case of Humana, the actors were:

• The health insurance system itself
• The customer, and
• The customer service representative

As you can see in the use case diagram above, the relational aspect is pretty simple. You have a customer service representative and a customer. They are both producing audio data, and that audio data is being fed into the system.

Humana focused on collecting the key data points, shown in the image below, from their customer service operations.

By collecting data about speech style, pitch, silence, stress in customers’ voices, length of call, speed of customers’ speech, intonation, articulation, silence, and representatives’  manner of speaking, Humana was able to analyze customer sentiment and introduce techniques for improved customer satisfaction.

Having strategically defined these data points, the Cogito technology was able to generate reports about customer sentiment during the calls.

Suggesting actions to customer service representatives.

The second use case for the Humana data program follows on from the data gathered in the first case.

In Humana’s case, Cogito generated a host of call analyses and reports about key call issues.

In the second business use case, Cogito was able to suggest actions to customer service representatives, in real-time , to make use of incoming data and help improve customer satisfaction on the spot.

The technology Humana used provided suggestions via text message to the customer service representative, offering the following types of feedback:

• The tone of voice is too tense
• The speed of speaking is high
• The customer representative and customer are speaking at the same time

These alerts allowed the Humana customer service representatives to alter their approach immediately , improving the quality of the interaction and, subsequently, the customer satisfaction.

The preconditions for success in this use case were:

• The call-related data must be collected and stored
• The AI models must be in place to generate analysis on the data points that are recorded during the calls

Evidence of success can subsequently be found in a system that offers real-time suggestions for courses of action that the customer service representative can take to improve customer satisfaction.

Thanks to this data-intensive business use case, Humana was able to increase customer satisfaction, improve customer retention rates, and drive profits per customer.

The Technology That Supports This Data Analysis Case Study

I promised to dip into the tech side of things. This is especially for those of you who are interested in the ins and outs of how projects like this one are actually rolled out.

Here’s a little rundown of the main technologies we discovered when we investigated how Cogito runs in support of its clients like Humana.

• For cloud data management Cogito uses AWS, specifically the Athena product
• For on-premise big data management, the company used Apache HDFS – the distributed file system for storing big data
• They utilize MapReduce, for processing their data
• And Cogito also has traditional systems and relational database management systems such as PostgreSQL
• In terms of analytics and data visualization tools, Cogito makes use of Tableau
• And for its machine learning technology, these use cases required people with knowledge in Python, R, and SQL, as well as deep learning (Cogito uses the PyTorch library and the TensorFlow library)

These data science skill sets support the effective computing, deep learning , and natural language processing applications employed by Humana for this use case.

If you’re looking to hire people to help with your own data initiative, then people with those skills listed above, and with experience in these specific technologies, would be a huge help.

Step 3: S elect The “Quick Win” Data Use Case

Still there? Great!

It’s time to close the loop.

Remember those notes you took before you reviewed the study? I want you to STOP here and assess. Does this Humana case study seem applicable and promising as a solution, given your organization’s current set-up…

YES ▶ Excellent!

Earmark it and continue exploring other winning data use cases until you’ve identified 5 that seem like great fits for your businesses needs. Evaluate those against your organization’s needs, and select the very best fit to be your “quick win” data use case. Develop your data strategy around that.

NO , Lillian – It’s not applicable. ▶  No problem.

Discard the information and continue exploring the winning data use cases we’ve categorized for you according to business function and industry. Save time by dialing down into the business function you know your business really needs help with now. Identify 5 winning data use cases that seem like great fits for your businesses needs. Evaluate those against your organization’s needs, and select the very best fit to be your “quick win” data use case. Develop your data strategy around that data use case.

More resources to get ahead...

Get income-generating ideas for data professionals, are you tired of relying on one employer for your income are you dreaming of a side hustle that won’t put you at risk of getting fired or sued well, my friend, you’re in luck..

This 48-page listing is here to rescue you from the drudgery of corporate slavery and set you on the path to start earning more money from your existing data expertise. Spend just 1 hour with this pdf and I can guarantee you’ll be bursting at the seams with practical, proven & profitable ideas for new income-streams you can create from your existing expertise. Learn more here!

Get the convergence newsletter.

Income-Generating Ideas For Data Professionals

A 48-page listing of income-generating product and service ideas for data professionals who want to earn additional money from their data expertise without relying on an employer to make it happen..

Data Strategy Action Plan

A step-by-step checklist & collaborative trello board planner for data professionals who want to get unstuck & up-leveled into their next promotion by delivering a fail-proof data strategy plan for their data projects..

Get more actionable advice by joining The Convergence Newsletter for free below.

NEW & Improved: Data Science for Dummies Book, Edition 3 Giveaway!!!

3 Affordable Tools for Successful Data Forecasting in 2021

Data Science Process Lifecycle: 8 Steps To Improving Yours By Developing A Business-Centric Data Use Case Framework

Machine Learning Security: Protecting Networks and Applications in Your ML Environment

What is a data leader & how you can become one (even if you don’t have a STEM degree!)

Data-science-for-dummies.

Fractional CMO for deep tech B2B businesses. Specializing in go-to-market strategy, SaaS product growth, and consulting revenue growth. American expat serving clients worldwide since 2012.

Get connected, © data-mania, 2012 - 2024+, all rights reserved - terms & conditions  -  privacy policy | products protected by copyscape, privacy overview.

Get The Newsletter

10 Real World Data Science Case Studies Projects with Example

Top 10 Data Science Case Studies Projects with Examples and Solutions in Python to inspire your data science learning in 2023.

BelData science has been a trending buzzword in recent times. With wide applications in various sectors like healthcare , education, retail, transportation, media, and banking -data science applications are at the core of pretty much every industry out there. The possibilities are endless: analysis of frauds in the finance sector or the personalization of recommendations on eCommerce businesses.  We have developed ten exciting data science case studies to explain how data science is leveraged across various industries to make smarter decisions and develop innovative personalized products tailored to specific customers.

Walmart Sales Forecasting Data Science Project

Downloadable solution code | Explanatory videos | Tech Support

Table of Contents

Data science case studies in retail , data science case study examples in entertainment industry , data analytics case study examples in travel industry , case studies for data analytics in social media , real world data science projects in healthcare, data analytics case studies in oil and gas, what is a case study in data science, how do you prepare a data science case study, 10 most interesting data science case studies with examples.

So, without much ado, let's get started with data science business case studies !

With humble beginnings as a simple discount retailer, today, Walmart operates in 10,500 stores and clubs in 24 countries and eCommerce websites, employing around 2.2 million people around the globe. For the fiscal year ended January 31, 2021, Walmart's total revenue was $559 billion showing a growth of $35 billion with the expansion of the eCommerce sector. Walmart is a data-driven company that works on the principle of 'Everyday low cost' for its consumers. To achieve this goal, they heavily depend on the advances of their data science and analytics department for research and development, also known as Walmart Labs. Walmart is home to the world's largest private cloud, which can manage 2.5 petabytes of data every hour! To analyze this humongous amount of data, Walmart has created 'Data Café,' a state-of-the-art analytics hub located within its Bentonville, Arkansas headquarters. The Walmart Labs team heavily invests in building and managing technologies like cloud, data, DevOps , infrastructure, and security.

Walmart is experiencing massive digital growth as the world's largest retailer . Walmart has been leveraging Big data and advances in data science to build solutions to enhance, optimize and customize the shopping experience and serve their customers in a better way. At Walmart Labs, data scientists are focused on creating data-driven solutions that power the efficiency and effectiveness of complex supply chain management processes. Here are some of the applications of data science  at Walmart:

i) Personalized Customer Shopping Experience

Walmart analyses customer preferences and shopping patterns to optimize the stocking and displaying of merchandise in their stores. Analysis of Big data also helps them understand new item sales, make decisions on discontinuing products, and the performance of brands.

ii) Order Sourcing and On-Time Delivery Promise

Millions of customers view items on Walmart.com, and Walmart provides each customer a real-time estimated delivery date for the items purchased. Walmart runs a backend algorithm that estimates this based on the distance between the customer and the fulfillment center, inventory levels, and shipping methods available. The supply chain management system determines the optimum fulfillment center based on distance and inventory levels for every order. It also has to decide on the shipping method to minimize transportation costs while meeting the promised delivery date.

Here's what valued users are saying about ProjectPro

Abhinav Agarwal

Graduate Student at Northwestern University

Ameeruddin Mohammed

ETL (Abintio) developer at IBM

Not sure what you are looking for?

iii) Packing Optimization 

Also known as Box recommendation is a daily occurrence in the shipping of items in retail and eCommerce business. When items of an order or multiple orders for the same customer are ready for packing, Walmart has developed a recommender system that picks the best-sized box which holds all the ordered items with the least in-box space wastage within a fixed amount of time. This Bin Packing problem is a classic NP-Hard problem familiar to data scientists .

Whenever items of an order or multiple orders placed by the same customer are picked from the shelf and are ready for packing, the box recommendation system determines the best-sized box to hold all the ordered items with a minimum of in-box space wasted. This problem is known as the Bin Packing Problem, another classic NP-Hard problem familiar to data scientists.

Here is a link to a sales prediction data science case study to help you understand the applications of Data Science in the real world. Walmart Sales Forecasting Project uses historical sales data for 45 Walmart stores located in different regions. Each store contains many departments, and you must build a model to project the sales for each department in each store. This data science case study aims to create a predictive model to predict the sales of each product. You can also try your hands-on Inventory Demand Forecasting Data Science Project to develop a machine learning model to forecast inventory demand accurately based on historical sales data.

Get Closer To Your Dream of Becoming a Data Scientist with 70+ Solved End-to-End ML Projects

Amazon is an American multinational technology-based company based in Seattle, USA. It started as an online bookseller, but today it focuses on eCommerce, cloud computing , digital streaming, and artificial intelligence . It hosts an estimate of 1,000,000,000 gigabytes of data across more than 1,400,000 servers. Through its constant innovation in data science and big data Amazon is always ahead in understanding its customers. Here are a few data analytics case study examples at Amazon:

i) Recommendation Systems

Data science models help amazon understand the customers' needs and recommend them to them before the customer searches for a product; this model uses collaborative filtering. Amazon uses 152 million customer purchases data to help users to decide on products to be purchased. The company generates 35% of its annual sales using the Recommendation based systems (RBS) method.

Here is a Recommender System Project to help you build a recommendation system using collaborative filtering. 

ii) Retail Price Optimization

Amazon product prices are optimized based on a predictive model that determines the best price so that the users do not refuse to buy it based on price. The model carefully determines the optimal prices considering the customers' likelihood of purchasing the product and thinks the price will affect the customers' future buying patterns. Price for a product is determined according to your activity on the website, competitors' pricing, product availability, item preferences, order history, expected profit margin, and other factors.

Check Out this Retail Price Optimization Project to build a Dynamic Pricing Model.

iii) Fraud Detection

Being a significant eCommerce business, Amazon remains at high risk of retail fraud. As a preemptive measure, the company collects historical and real-time data for every order. It uses Machine learning algorithms to find transactions with a higher probability of being fraudulent. This proactive measure has helped the company restrict clients with an excessive number of returns of products.

You can look at this Credit Card Fraud Detection Project to implement a fraud detection model to classify fraudulent credit card transactions.

New Projects

Let us explore data analytics case study examples in the entertainment indusry.

Ace Your Next Job Interview with Mock Interviews from Experts to Improve Your Skills and Boost Confidence!

Netflix started as a DVD rental service in 1997 and then has expanded into the streaming business. Headquartered in Los Gatos, California, Netflix is the largest content streaming company in the world. Currently, Netflix has over 208 million paid subscribers worldwide, and with thousands of smart devices which are presently streaming supported, Netflix has around 3 billion hours watched every month. The secret to this massive growth and popularity of Netflix is its advanced use of data analytics and recommendation systems to provide personalized and relevant content recommendations to its users. The data is collected over 100 billion events every day. Here are a few examples of data analysis case studies applied at Netflix :

i) Personalized Recommendation System

Netflix uses over 1300 recommendation clusters based on consumer viewing preferences to provide a personalized experience. Some of the data that Netflix collects from its users include Viewing time, platform searches for keywords, Metadata related to content abandonment, such as content pause time, rewind, rewatched. Using this data, Netflix can predict what a viewer is likely to watch and give a personalized watchlist to a user. Some of the algorithms used by the Netflix recommendation system are Personalized video Ranking, Trending now ranker, and the Continue watching now ranker.

ii) Content Development using Data Analytics

Netflix uses data science to analyze the behavior and patterns of its user to recognize themes and categories that the masses prefer to watch. This data is used to produce shows like The umbrella academy, and Orange Is the New Black, and the Queen's Gambit. These shows seem like a huge risk but are significantly based on data analytics using parameters, which assured Netflix that they would succeed with its audience. Data analytics is helping Netflix come up with content that their viewers want to watch even before they know they want to watch it.

iii) Marketing Analytics for Campaigns

Netflix uses data analytics to find the right time to launch shows and ad campaigns to have maximum impact on the target audience. Marketing analytics helps come up with different trailers and thumbnails for other groups of viewers. For example, the House of Cards Season 5 trailer with a giant American flag was launched during the American presidential elections, as it would resonate well with the audience.

Here is a Customer Segmentation Project using association rule mining to understand the primary grouping of customers based on various parameters.

Get FREE Access to Machine Learning Example Codes for Data Cleaning , Data Munging, and Data Visualization

In a world where Purchasing music is a thing of the past and streaming music is a current trend, Spotify has emerged as one of the most popular streaming platforms. With 320 million monthly users, around 4 billion playlists, and approximately 2 million podcasts, Spotify leads the pack among well-known streaming platforms like Apple Music, Wynk, Songza, amazon music, etc. The success of Spotify has mainly depended on data analytics. By analyzing massive volumes of listener data, Spotify provides real-time and personalized services to its listeners. Most of Spotify's revenue comes from paid premium subscriptions. Here are some of the examples of case study on data analytics used by Spotify to provide enhanced services to its listeners:

i) Personalization of Content using Recommendation Systems

Spotify uses Bart or Bayesian Additive Regression Trees to generate music recommendations to its listeners in real-time. Bart ignores any song a user listens to for less than 30 seconds. The model is retrained every day to provide updated recommendations. A new Patent granted to Spotify for an AI application is used to identify a user's musical tastes based on audio signals, gender, age, accent to make better music recommendations.

Spotify creates daily playlists for its listeners, based on the taste profiles called 'Daily Mixes,' which have songs the user has added to their playlists or created by the artists that the user has included in their playlists. It also includes new artists and songs that the user might be unfamiliar with but might improve the playlist. Similar to it is the weekly 'Release Radar' playlists that have newly released artists' songs that the listener follows or has liked before.

ii) Targetted marketing through Customer Segmentation

With user data for enhancing personalized song recommendations, Spotify uses this massive dataset for targeted ad campaigns and personalized service recommendations for its users. Spotify uses ML models to analyze the listener's behavior and group them based on music preferences, age, gender, ethnicity, etc. These insights help them create ad campaigns for a specific target audience. One of their well-known ad campaigns was the meme-inspired ads for potential target customers, which was a huge success globally.

iii) CNN's for Classification of Songs and Audio Tracks

Spotify builds audio models to evaluate the songs and tracks, which helps develop better playlists and recommendations for its users. These allow Spotify to filter new tracks based on their lyrics and rhythms and recommend them to users like similar tracks ( collaborative filtering). Spotify also uses NLP ( Natural language processing) to scan articles and blogs to analyze the words used to describe songs and artists. These analytical insights can help group and identify similar artists and songs and leverage them to build playlists.

Here is a Music Recommender System Project for you to start learning. We have listed another music recommendations dataset for you to use for your projects: Dataset1 . You can use this dataset of Spotify metadata to classify songs based on artists, mood, liveliness. Plot histograms, heatmaps to get a better understanding of the dataset. Use classification algorithms like logistic regression, SVM, and Principal component analysis to generate valuable insights from the dataset.

Explore Categories

Below you will find case studies for data analytics in the travel and tourism industry.

Airbnb was born in 2007 in San Francisco and has since grown to 4 million Hosts and 5.6 million listings worldwide who have welcomed more than 1 billion guest arrivals in almost every country across the globe. Airbnb is active in every country on the planet except for Iran, Sudan, Syria, and North Korea. That is around 97.95% of the world. Using data as a voice of their customers, Airbnb uses the large volume of customer reviews, host inputs to understand trends across communities, rate user experiences, and uses these analytics to make informed decisions to build a better business model. The data scientists at Airbnb are developing exciting new solutions to boost the business and find the best mapping for its customers and hosts. Airbnb data servers serve approximately 10 million requests a day and process around one million search queries. Data is the voice of customers at AirBnB and offers personalized services by creating a perfect match between the guests and hosts for a supreme customer experience. 

i) Recommendation Systems and Search Ranking Algorithms

Airbnb helps people find 'local experiences' in a place with the help of search algorithms that make searches and listings precise. Airbnb uses a 'listing quality score' to find homes based on the proximity to the searched location and uses previous guest reviews. Airbnb uses deep neural networks to build models that take the guest's earlier stays into account and area information to find a perfect match. The search algorithms are optimized based on guest and host preferences, rankings, pricing, and availability to understand users’ needs and provide the best match possible.

ii) Natural Language Processing for Review Analysis

Airbnb characterizes data as the voice of its customers. The customer and host reviews give a direct insight into the experience. The star ratings alone cannot be an excellent way to understand it quantitatively. Hence Airbnb uses natural language processing to understand reviews and the sentiments behind them. The NLP models are developed using Convolutional neural networks .

Practice this Sentiment Analysis Project for analyzing product reviews to understand the basic concepts of natural language processing.

iii) Smart Pricing using Predictive Analytics

The Airbnb hosts community uses the service as a supplementary income. The vacation homes and guest houses rented to customers provide for rising local community earnings as Airbnb guests stay 2.4 times longer and spend approximately 2.3 times the money compared to a hotel guest. The profits are a significant positive impact on the local neighborhood community. Airbnb uses predictive analytics to predict the prices of the listings and help the hosts set a competitive and optimal price. The overall profitability of the Airbnb host depends on factors like the time invested by the host and responsiveness to changing demands for different seasons. The factors that impact the real-time smart pricing are the location of the listing, proximity to transport options, season, and amenities available in the neighborhood of the listing.

Here is a Price Prediction Project to help you understand the concept of predictive analysis which is widely common in case studies for data analytics. 

Uber is the biggest global taxi service provider. As of December 2018, Uber has 91 million monthly active consumers and 3.8 million drivers. Uber completes 14 million trips each day. Uber uses data analytics and big data-driven technologies to optimize their business processes and provide enhanced customer service. The Data Science team at uber has been exploring futuristic technologies to provide better service constantly. Machine learning and data analytics help Uber make data-driven decisions that enable benefits like ride-sharing, dynamic price surges, better customer support, and demand forecasting. Here are some of the real world data science projects used by uber:

i) Dynamic Pricing for Price Surges and Demand Forecasting

Uber prices change at peak hours based on demand. Uber uses surge pricing to encourage more cab drivers to sign up with the company, to meet the demand from the passengers. When the prices increase, the driver and the passenger are both informed about the surge in price. Uber uses a predictive model for price surging called the 'Geosurge' ( patented). It is based on the demand for the ride and the location.

ii) One-Click Chat

Uber has developed a Machine learning and natural language processing solution called one-click chat or OCC for coordination between drivers and users. This feature anticipates responses for commonly asked questions, making it easy for the drivers to respond to customer messages. Drivers can reply with the clock of just one button. One-Click chat is developed on Uber's machine learning platform Michelangelo to perform NLP on rider chat messages and generate appropriate responses to them.

iii) Customer Retention

Failure to meet the customer demand for cabs could lead to users opting for other services. Uber uses machine learning models to bridge this demand-supply gap. By using prediction models to predict the demand in any location, uber retains its customers. Uber also uses a tier-based reward system, which segments customers into different levels based on usage. The higher level the user achieves, the better are the perks. Uber also provides personalized destination suggestions based on the history of the user and their frequently traveled destinations.

You can take a look at this Python Chatbot Project and build a simple chatbot application to understand better the techniques used for natural language processing. You can also practice the working of a demand forecasting model with this project using time series analysis. You can look at this project which uses time series forecasting and clustering on a dataset containing geospatial data for forecasting customer demand for ola rides.

Explore More  Data Science and Machine Learning Projects for Practice. Fast-Track Your Career Transition with ProjectPro

7) LinkedIn 

LinkedIn is the largest professional social networking site with nearly 800 million members in more than 200 countries worldwide. Almost 40% of the users access LinkedIn daily, clocking around 1 billion interactions per month. The data science team at LinkedIn works with this massive pool of data to generate insights to build strategies, apply algorithms and statistical inferences to optimize engineering solutions, and help the company achieve its goals. Here are some of the real world data science projects at LinkedIn:

i) LinkedIn Recruiter Implement Search Algorithms and Recommendation Systems

LinkedIn Recruiter helps recruiters build and manage a talent pool to optimize the chances of hiring candidates successfully. This sophisticated product works on search and recommendation engines. The LinkedIn recruiter handles complex queries and filters on a constantly growing large dataset. The results delivered have to be relevant and specific. The initial search model was based on linear regression but was eventually upgraded to Gradient Boosted decision trees to include non-linear correlations in the dataset. In addition to these models, the LinkedIn recruiter also uses the Generalized Linear Mix model to improve the results of prediction problems to give personalized results.

ii) Recommendation Systems Personalized for News Feed

The LinkedIn news feed is the heart and soul of the professional community. A member's newsfeed is a place to discover conversations among connections, career news, posts, suggestions, photos, and videos. Every time a member visits LinkedIn, machine learning algorithms identify the best exchanges to be displayed on the feed by sorting through posts and ranking the most relevant results on top. The algorithms help LinkedIn understand member preferences and help provide personalized news feeds. The algorithms used include logistic regression, gradient boosted decision trees and neural networks for recommendation systems.

iii) CNN's to Detect Inappropriate Content

To provide a professional space where people can trust and express themselves professionally in a safe community has been a critical goal at LinkedIn. LinkedIn has heavily invested in building solutions to detect fake accounts and abusive behavior on their platform. Any form of spam, harassment, inappropriate content is immediately flagged and taken down. These can range from profanity to advertisements for illegal services. LinkedIn uses a Convolutional neural networks based machine learning model. This classifier trains on a training dataset containing accounts labeled as either "inappropriate" or "appropriate." The inappropriate list consists of accounts having content from "blocklisted" phrases or words and a small portion of manually reviewed accounts reported by the user community.

Here is a Text Classification Project to help you understand NLP basics for text classification. You can find a news recommendation system dataset to help you build a personalized news recommender system. You can also use this dataset to build a classifier using logistic regression, Naive Bayes, or Neural networks to classify toxic comments.

Get confident to build end-to-end projects

Access to a curated library of 250+ end-to-end industry projects with solution code, videos and tech support.

Pfizer is a multinational pharmaceutical company headquartered in New York, USA. One of the largest pharmaceutical companies globally known for developing a wide range of medicines and vaccines in disciplines like immunology, oncology, cardiology, and neurology. Pfizer became a household name in 2010 when it was the first to have a COVID-19 vaccine with FDA. In early November 2021, The CDC has approved the Pfizer vaccine for kids aged 5 to 11. Pfizer has been using machine learning and artificial intelligence to develop drugs and streamline trials, which played a massive role in developing and deploying the COVID-19 vaccine. Here are a few data analytics case studies by Pfizer :

i) Identifying Patients for Clinical Trials

Artificial intelligence and machine learning are used to streamline and optimize clinical trials to increase their efficiency. Natural language processing and exploratory data analysis of patient records can help identify suitable patients for clinical trials. These can help identify patients with distinct symptoms. These can help examine interactions of potential trial members' specific biomarkers, predict drug interactions and side effects which can help avoid complications. Pfizer's AI implementation helped rapidly identify signals within the noise of millions of data points across their 44,000-candidate COVID-19 clinical trial.

ii) Supply Chain and Manufacturing

Data science and machine learning techniques help pharmaceutical companies better forecast demand for vaccines and drugs and distribute them efficiently. Machine learning models can help identify efficient supply systems by automating and optimizing the production steps. These will help supply drugs customized to small pools of patients in specific gene pools. Pfizer uses Machine learning to predict the maintenance cost of equipment used. Predictive maintenance using AI is the next big step for Pharmaceutical companies to reduce costs.

iii) Drug Development

Computer simulations of proteins, and tests of their interactions, and yield analysis help researchers develop and test drugs more efficiently. In 2016 Watson Health and Pfizer announced a collaboration to utilize IBM Watson for Drug Discovery to help accelerate Pfizer's research in immuno-oncology, an approach to cancer treatment that uses the body's immune system to help fight cancer. Deep learning models have been used recently for bioactivity and synthesis prediction for drugs and vaccines in addition to molecular design. Deep learning has been a revolutionary technique for drug discovery as it factors everything from new applications of medications to possible toxic reactions which can save millions in drug trials.

You can create a Machine learning model to predict molecular activity to help design medicine using this dataset . You may build a CNN or a Deep neural network for this data analyst case study project.

Access Data Science and Machine Learning Project Code Examples

9) Shell Data Analyst Case Study Project

Shell is a global group of energy and petrochemical companies with over 80,000 employees in around 70 countries. Shell uses advanced technologies and innovations to help build a sustainable energy future. Shell is going through a significant transition as the world needs more and cleaner energy solutions to be a clean energy company by 2050. It requires substantial changes in the way in which energy is used. Digital technologies, including AI and Machine Learning, play an essential role in this transformation. These include efficient exploration and energy production, more reliable manufacturing, more nimble trading, and a personalized customer experience. Using AI in various phases of the organization will help achieve this goal and stay competitive in the market. Here are a few data analytics case studies in the petrochemical industry:

i) Precision Drilling

Shell is involved in the processing mining oil and gas supply, ranging from mining hydrocarbons to refining the fuel to retailing them to customers. Recently Shell has included reinforcement learning to control the drilling equipment used in mining. Reinforcement learning works on a reward-based system based on the outcome of the AI model. The algorithm is designed to guide the drills as they move through the surface, based on the historical data from drilling records. It includes information such as the size of drill bits, temperatures, pressures, and knowledge of the seismic activity. This model helps the human operator understand the environment better, leading to better and faster results will minor damage to machinery used. 

ii) Efficient Charging Terminals

Due to climate changes, governments have encouraged people to switch to electric vehicles to reduce carbon dioxide emissions. However, the lack of public charging terminals has deterred people from switching to electric cars. Shell uses AI to monitor and predict the demand for terminals to provide efficient supply. Multiple vehicles charging from a single terminal may create a considerable grid load, and predictions on demand can help make this process more efficient.

iii) Monitoring Service and Charging Stations

Another Shell initiative trialed in Thailand and Singapore is the use of computer vision cameras, which can think and understand to watch out for potentially hazardous activities like lighting cigarettes in the vicinity of the pumps while refueling. The model is built to process the content of the captured images and label and classify it. The algorithm can then alert the staff and hence reduce the risk of fires. You can further train the model to detect rash driving or thefts in the future.

Here is a project to help you understand multiclass image classification. You can use the Hourly Energy Consumption Dataset to build an energy consumption prediction model. You can use time series with XGBoost to develop your model.

10) Zomato Case Study on Data Analytics

Zomato was founded in 2010 and is currently one of the most well-known food tech companies. Zomato offers services like restaurant discovery, home delivery, online table reservation, online payments for dining, etc. Zomato partners with restaurants to provide tools to acquire more customers while also providing delivery services and easy procurement of ingredients and kitchen supplies. Currently, Zomato has over 2 lakh restaurant partners and around 1 lakh delivery partners. Zomato has closed over ten crore delivery orders as of date. Zomato uses ML and AI to boost their business growth, with the massive amount of data collected over the years from food orders and user consumption patterns. Here are a few examples of data analyst case study project developed by the data scientists at Zomato:

i) Personalized Recommendation System for Homepage

Zomato uses data analytics to create personalized homepages for its users. Zomato uses data science to provide order personalization, like giving recommendations to the customers for specific cuisines, locations, prices, brands, etc. Restaurant recommendations are made based on a customer's past purchases, browsing history, and what other similar customers in the vicinity are ordering. This personalized recommendation system has led to a 15% improvement in order conversions and click-through rates for Zomato. 

You can use the Restaurant Recommendation Dataset to build a restaurant recommendation system to predict what restaurants customers are most likely to order from, given the customer location, restaurant information, and customer order history.

ii) Analyzing Customer Sentiment

Zomato uses Natural language processing and Machine learning to understand customer sentiments using social media posts and customer reviews. These help the company gauge the inclination of its customer base towards the brand. Deep learning models analyze the sentiments of various brand mentions on social networking sites like Twitter, Instagram, Linked In, and Facebook. These analytics give insights to the company, which helps build the brand and understand the target audience.

iii) Predicting Food Preparation Time (FPT)

Food delivery time is an essential variable in the estimated delivery time of the order placed by the customer using Zomato. The food preparation time depends on numerous factors like the number of dishes ordered, time of the day, footfall in the restaurant, day of the week, etc. Accurate prediction of the food preparation time can help make a better prediction of the Estimated delivery time, which will help delivery partners less likely to breach it. Zomato uses a Bidirectional LSTM-based deep learning model that considers all these features and provides food preparation time for each order in real-time. 

Data scientists are companies' secret weapons when analyzing customer sentiments and behavior and leveraging it to drive conversion, loyalty, and profits. These 10 data science case studies projects with examples and solutions show you how various organizations use data science technologies to succeed and be at the top of their field! To summarize, Data Science has not only accelerated the performance of companies but has also made it possible to manage & sustain their performance with ease.

FAQs on Data Analysis Case Studies

A case study in data science is an in-depth analysis of a real-world problem using data-driven approaches. It involves collecting, cleaning, and analyzing data to extract insights and solve challenges, offering practical insights into how data science techniques can address complex issues across various industries.

To create a data science case study, identify a relevant problem, define objectives, and gather suitable data. Clean and preprocess data, perform exploratory data analysis, and apply appropriate algorithms for analysis. Summarize findings, visualize results, and provide actionable recommendations, showcasing the problem-solving potential of data science techniques.

About the Author

ProjectPro is the only online platform designed to help professionals gain practical, hands-on experience in big data, data engineering, data science, and machine learning related technologies. Having over 270+ reusable project templates in data science and big data with step-by-step walkthroughs,

© 2024

© 2024 Iconiq Inc.

Privacy policy

User policy

Write for ProjectPro

An official website of the United States government

Here’s how you know

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Case studies & examples

Articles, use cases, and proof points describing projects undertaken by data managers and data practitioners across the federal government

Agencies Mobilize to Improve Emergency Response in Puerto Rico through Better Data

Federal agencies' response efforts to Hurricanes Irma and Maria in Puerto Rico was hampered by imperfect address data for the island. In the aftermath, emergency responders gathered together to enhance the utility of Puerto Rico address data and share best practices for using what information is currently available.

Federal Data Strategy

BUILDER: A Science-Based Approach to Infrastructure Management

The Department of Energy’s National Nuclear Security Administration (NNSA) adopted a data-driven, risk-informed strategy to better assess risks, prioritize investments, and cost effectively modernize its aging nuclear infrastructure. NNSA’s new strategy, and lessons learned during its implementation, will help inform other federal data practitioners’ efforts to maintain facility-level information while enabling accurate and timely enterprise-wide infrastructure analysis.

Department of Energy

data management , data analysis , process redesign , Federal Data Strategy

Business case for open data

Six reasons why making your agency's data open and accessible is a good business decision.

CDO Council Federal HR Dashboarding Report - 2021

The CDO Council worked with the US Department of Agriculture, the Department of the Treasury, the United States Agency for International Development, and the Department of Transportation to develop a Diversity Profile Dashboard and to explore the value of shared HR decision support across agencies. The pilot was a success, and identified potential impact of a standardized suite of HR dashboards, in addition to demonstrating the value of collaborative analytics between agencies.

Federal Chief Data Officer's Council

data practices , data sharing , data access

CDOC Data Inventory Report

The Chief Data Officers Council Data Inventory Working Group developed this paper to highlight the value proposition for data inventories and describe challenges agencies may face when implementing and managing comprehensive data inventories. It identifies opportunities agencies can take to overcome some of these challenges and includes a set of recommendations directed at Agencies, OMB, and the CDO Council (CDOC).

data practices , metadata , data inventory

DSWG Recommendations and Findings

The Chief Data Officer Council (CDOC) established a Data Sharing Working Group (DSWG) to help the council understand the varied data-sharing needs and challenges of all agencies across the Federal Government. The DSWG reviewed data-sharing across federal agencies and developed a set of recommendations for improving the methods to access and share data within and between agencies. This report presents the findings of the DSWG’s review and provides recommendations to the CDOC Executive Committee.

data practices , data agreements , data sharing , data access

Data Skills Training Program Implementation Toolkit

The Data Skills Training Program Implementation Toolkit is designed to provide both small and large agencies with information to develop their own data skills training programs. The information provided will serve as a roadmap to the design, implementation, and administration of federal data skills training programs as agencies address their Federal Data Strategy’s Agency Action 4 gap-closing strategy training component.

data sharing , Federal Data Strategy

Data Standdown: Interrupting process to fix information

Although not a true pause in operations, ONR’s data standdown made data quality and data consolidation the top priority for the entire organization. It aimed to establish an automated and repeatable solution to enable a more holistic view of ONR investments and activities, and to increase transparency and effectiveness throughout its mission support functions. In addition, it demonstrated that getting top-level buy-in from management to prioritize data can truly advance a more data-driven culture.

Office of Naval Research

data governance , data cleaning , process redesign , Federal Data Strategy

Data.gov Metadata Management Services Product-Preliminary Plan

Status summary and preliminary business plan for a potential metadata management product under development by the Data.gov Program Management Office

data management , Federal Data Strategy , metadata , open data

PDF (7 pages)

Department of Transportation Case Study: Enterprise Data Inventory

In response to the Open Government Directive, DOT developed a strategic action plan to inventory and release high-value information through the Data.gov portal. The Department sustained efforts in building its data inventory, responding to the President’s memorandum on regulatory compliance with a comprehensive plan that was recognized as a model for other agencies to follow.

Department of Transportation

data inventory , open data

Department of Transportation Model Data Inventory Approach

This document from the Department of Transportation provides a model plan for conducting data inventory efforts required under OMB Memorandum M-13-13.

data inventory

PDF (5 pages)

FEMA Case Study: Disaster Assistance Program Coordination

In 2008, the Disaster Assistance Improvement Program (DAIP), an E-Government initiative led by FEMA with support from 16 U.S. Government partners, launched DisasterAssistance.gov to simplify the process for disaster survivors to identify and apply for disaster assistance. DAIP utilized existing partner technologies and implemented a services oriented architecture (SOA) that integrated the content management system and rules engine supporting Department of Labor’s Benefits.gov applications with FEMA’s Individual Assistance Center application. The FEMA SOA serves as the backbone for data sharing interfaces with three of DAIP’s federal partners and transfers application data to reduce duplicate data entry by disaster survivors.

Federal Emergency Management Agency

data sharing

Federal CDO Data Skills Training Program Case Studies

This series was developed by the Chief Data Officer Council’s Data Skills & Workforce Development Working Group to provide support to agencies in implementing the Federal Data Strategy’s Agency Action 4 gap-closing strategy training component in FY21.

FederalRegister.gov API Case Study

This case study describes the tenets behind an API that provides access to all data found on FederalRegister.gov, including all Federal Register documents from 1994 to the present.

National Archives and Records Administration

PDF (3 pages)

Fuels Knowledge Graph Project

The Fuels Knowledge Graph Project (FKGP), funded through the Federal Chief Data Officers (CDO) Council, explored the use of knowledge graphs to achieve more consistent and reliable fuel management performance measures. The team hypothesized that better performance measures and an interoperable semantic framework could enhance the ability to understand wildfires and, ultimately, improve outcomes. To develop a more systematic and robust characterization of program outcomes, the FKGP team compiled, reviewed, and analyzed multiple agency glossaries and data sources. The team examined the relationships between them, while documenting the data management necessary for a successful fuels management program.

metadata , data sharing , data access

Government Data Hubs

A list of Federal agency open data hubs, including USDA, HHS, NASA, and many others.

Helping Baltimore Volunteers Find Where to Help

Bloomberg Government analysts put together a prototype through the Census Bureau’s Opportunity Project to better assess where volunteers should direct litter-clearing efforts. Using Census Bureau and Forest Service information, the team brought a data-driven approach to their work. Their experience reveals how individuals with data expertise can identify a real-world problem that data can help solve, navigate across agencies to find and obtain the most useful data, and work within resource constraints to provide a tool to help address the problem.

Census Bureau

geospatial , data sharing , Federal Data Strategy

How USDA Linked Federal and Commercial Data to Shed Light on the Nutritional Value of Retail Food Sales

Purchase-to-Plate Crosswalk (PPC) links the more than 359,000 food products in a comercial company database to several thousand foods in a series of USDA nutrition databases. By linking existing data resources, USDA was able to enrich and expand the analysis capabilities of both datasets. Since there were no common identifiers between the two data structures, the team used probabilistic and semantic methods to reduce the manual effort required to link the data.

Department of Agriculture

data sharing , process redesign , Federal Data Strategy

How to Blend Your Data: BEA and BLS Harness Big Data to Gain New Insights about Foreign Direct Investment in the U.S.

A recent collaboration between the Bureau of Economic Analysis (BEA) and the Bureau of Labor Statistics (BLS) helps shed light on the segment of the American workforce employed by foreign multinational companies. This case study shows the opportunities of cross-agency data collaboration, as well as some of the challenges of using big data and administrative data in the federal government.

Bureau of Economic Analysis / Bureau of Labor Statistics

data sharing , workforce development , process redesign , Federal Data Strategy

Implementing Federal-Wide Comment Analysis Tools

The CDO Council Comment Analysis pilot has shown that recent advances in Natural Language Processing (NLP) can effectively aid the regulatory comment analysis process. The proof-ofconcept is a standardized toolset intended to support agencies and staff in reviewing and responding to the millions of public comments received each year across government.

Improving Data Access and Data Management: Artificial Intelligence-Generated Metadata Tags at NASA

NASA’s data scientists and research content managers recently built an automated tagging system using machine learning and natural language processing. This system serves as an example of how other agencies can use their own unstructured data to improve information accessibility and promote data reuse.

National Aeronautics and Space Administration

metadata , data management , data sharing , process redesign , Federal Data Strategy

Investing in Learning with the Data Stewardship Tactical Working Group at DHS

The Department of Homeland Security (DHS) experience forming the Data Stewardship Tactical Working Group (DSTWG) provides meaningful insights for those who want to address data-related challenges collaboratively and successfully in their own agencies.

Department of Homeland Security

data governance , data management , Federal Data Strategy

Leveraging AI for Business Process Automation at NIH

The National Institute of General Medical Sciences (NIGMS), one of the twenty-seven institutes and centers at the NIH, recently deployed Natural Language Processing (NLP) and Machine Learning (ML) to automate the process by which it receives and internally refers grant applications. This new approach ensures efficient and consistent grant application referral, and liberates Program Managers from the labor-intensive and monotonous referral process.

National Institutes of Health

standards , data cleaning , process redesign , AI

FDS Proof Point

National Broadband Map: A Case Study on Open Innovation for National Policy

The National Broadband Map is a tool that provide consumers nationwide reliable information on broadband internet connections. This case study describes how crowd-sourcing, open source software, and public engagement informs the development of a tool that promotes government transparency.

Federal Communications Commission

National Renewable Energy Laboratory API Case Study

This case study describes the launch of the National Renewable Energy Laboratory (NREL) Developer Network in October 2011. The main goal was to build an overarching platform to make it easier for the public to use NREL APIs and for NREL to produce APIs.

National Renewable Energy Laboratory

Open Energy Data at DOE

This case study details the development of the renewable energy applications built on the Open Energy Information (OpenEI) platform, sponsored by the Department of Energy (DOE) and implemented by the National Renewable Energy Laboratory (NREL).

open data , data sharing , Federal Data Strategy

Pairing Government Data with Private-Sector Ingenuity to Take on Unwanted Calls

The Federal Trade Commission (FTC) releases data from millions of consumer complaints about unwanted calls to help fuel a myriad of private-sector solutions to tackle the problem. The FTC’s work serves as an example of how agencies can work with the private sector to encourage the innovative use of government data toward solutions that benefit the public.

Federal Trade Commission

data cleaning , Federal Data Strategy , open data , data sharing

Profile in Data Sharing - National Electronic Interstate Compact Enterprise

The Federal CDO Council’s Data Sharing Working Group highlights successful data sharing activities to recognize mature data sharing practices as well as to incentivize and inspire others to take part in similar collaborations. This Profile in Data Sharing focuses on how the federal government and states support children who are being placed for adoption or foster care across state lines. It greatly reduces the work and time required for states to exchange paperwork and information needed to process the placements. Additionally, NEICE allows child welfare workers to communicate and provide timely updates to courts, relevant private service providers, and families.

Profile in Data Sharing - National Health Service Corps Loan Repayment Programs

The Federal CDO Council’s Data Sharing Working Group highlights successful data sharing activities to recognize mature data sharing practices as well as to incentivize and inspire others to take part in similar collaborations. This Profile in Data Sharing focuses on how the Health Resources and Services Administration collaborates with the Department of Education to make it easier to apply to serve medically underserved communities - reducing applicant burden and improving processing efficiency.

Profile in Data Sharing - Roadside Inspection Data

The Federal CDO Council’s Data Sharing Working Group highlights successful data sharing activities to recognize mature data sharing practices as well as to incentivize and inspire others to take part in similar collaborations. This Profile in Data Sharing focuses on how the Department of Transportation collaborates with the Customs and Border Patrol and state partners to prescreen commercial motor vehicles entering the US and to focus inspections on unsafe carriers and drivers.

Profiles in Data Sharing - U.S. Citizenship and Immigration Service

The Federal CDO Council’s Data Sharing Working Group highlights successful data sharing activities to recognize mature data sharing practices as well as to incentivize and inspire others to take part in similar collaborations. This Profile in Data Sharing focuses on how the U.S. Citizenship and Immigration Service (USCIS) collaborated with the Centers for Disease Control to notify state, local, tribal, and territorial public health authorities so they can connect with individuals in their communities about their potential exposure.

SBA’s Approach to Identifying Data, Using a Learning Agenda, and Leveraging Partnerships to Build its Evidence Base

Through its Enterprise Learning Agenda, Small Business Administration’s (SBA) staff identify essential research questions, a plan to answer them, and how data held outside the agency can help provide further insights. Other agencies can learn from the innovative ways SBA identifies data to answer agency strategic questions and adopt those aspects that work for their own needs.

Small Business Administration

process redesign , Federal Data Strategy

Supercharging Data through Validation as a Service

USDA's Food and Nutrition Service restructured its approach to data validation at the state level using an open-source, API-based validation service managed at the federal level.

data cleaning , data validation , API , data sharing , process redesign , Federal Data Strategy

The Census Bureau Uses Its Own Data to Increase Response Rates, Helps Communities and Other Stakeholders Do the Same

The Census Bureau team produced a new interactive mapping tool in early 2018 called the Response Outreach Area Mapper (ROAM), an application that resulted in wider use of authoritative Census Bureau data, not only to improve the Census Bureau’s own operational efficiency, but also for use by tribal, state, and local governments, national and local partners, and other community groups. Other agency data practitioners can learn from the Census Bureau team’s experience communicating technical needs to non-technical executives, building analysis tools with widely-used software, and integrating efforts with stakeholders and users.

open data , data sharing , data management , data analysis , Federal Data Strategy

The Mapping Medicare Disparities Tool

The Centers for Medicare & Medicaid Services’ Office of Minority Health (CMS OMH) Mapping Medicare Disparities Tool harnessed the power of millions of data records while protecting the privacy of individuals, creating an easy-to-use tool to better understand health disparities.

Centers for Medicare & Medicaid Services

geospatial , Federal Data Strategy , open data

The Veterans Legacy Memorial

The Veterans Legacy Memorial (VLM) is a digital platform to help families, survivors, and fellow veterans to take a leading role in honoring their beloved veteran. Built on millions of existing National Cemetery Administration (NCA) records in a 25-year-old database, VLM is a powerful example of an agency harnessing the potential of a legacy system to provide a modernized service that better serves the public.

Veterans Administration

data sharing , data visualization , Federal Data Strategy

Transitioning to a Data Driven Culture at CMS

This case study describes how CMS announced the creation of the Office of Information Products and Data Analytics (OIPDA) to take the lead in making data use and dissemination a core function of the agency.

data management , data sharing , data analysis , data analytics

PDF (10 pages)

U.S. Department of Labor Case Study: Software Development Kits

The U.S. Department of Labor sought to go beyond merely making data available to developers and take ease of use of the data to the next level by giving developers tools that would make using DOL’s data easier. DOL created software development kits (SDKs), which are downloadable code packages that developers can drop into their apps, making access to DOL’s data easy for even the most novice developer. These SDKs have even been published as open source projects with the aim of speeding up their conversion to SDKs that will eventually support all federal APIs.

Department of Labor

open data , API

U.S. Geological Survey and U.S. Census Bureau collaborate on national roads and boundaries data

It is a well-kept secret that the U.S. Geological Survey and the U.S. Census Bureau were the original two federal agencies to build the first national digital database of roads and boundaries in the United States. The agencies joined forces to develop homegrown computer software and state of the art technologies to convert existing USGS topographic maps of the nation to the points, lines, and polygons that fueled early GIS. Today, the USGS and Census Bureau have a longstanding goal to leverage and use roads and authoritative boundary datasets.

U.S. Geological Survey and U.S. Census Bureau

data management , data sharing , data standards , data validation , data visualization , Federal Data Strategy , geospatial , open data , quality

USA.gov Uses Human-Centered Design to Roll Out AI Chatbot

To improve customer service and give better answers to users of the USA.gov website, the Technology Transformation and Services team at General Services Administration (GSA) created a chatbot using artificial intelligence (AI) and automation.

General Services Administration

AI , Federal Data Strategy

resources.data.gov

An official website of the Office of Management and Budget, the General Services Administration, and the Office of Government Information Services.

This section contains explanations of common terms referenced on resources.data.gov.

Data Analytics Case Study Guide (Updated for 2024)

What are data analytics case study interviews.

When you’re trying to land a data analyst job, the last thing to stand in your way is the data analytics case study interview.

One reason they’re so challenging is that case studies don’t typically have a right or wrong answer.

Instead, case study interviews require you to come up with a hypothesis for an analytics question and then produce data to support or validate your hypothesis. In other words, it’s not just about your technical skills; you’re also being tested on creative problem-solving and your ability to communicate with stakeholders.

This article provides an overview of how to answer data analytics case study interview questions. You can find an in-depth course in the data analytics learning path .

How to Solve Data Analytics Case Questions

Check out our video below on How to solve a Data Analytics case study problem:

With data analyst case questions, you will need to answer two key questions:

• What metrics should I propose?
• How do I write a SQL query to get the metrics I need?

In short, to ace a data analytics case interview, you not only need to brush up on case questions, but you also should be adept at writing all types of SQL queries and have strong data sense.

These questions are especially challenging to answer if you don’t have a framework or know how to answer them. To help you prepare, we created this step-by-step guide to answering data analytics case questions.

We show you how to use a framework to answer case questions, provide example analytics questions, and help you understand the difference between analytics case studies and product metrics case studies .

Data Analytics Cases vs Product Metrics Questions

Product case questions sometimes get lumped in with data analytics cases.

Ultimately, the type of case question you are asked will depend on the role. For example, product analysts will likely face more product-oriented questions.

Product metrics cases tend to focus on a hypothetical situation. You might be asked to:

Investigate Metrics - One of the most common types will ask you to investigate a metric, usually one that’s going up or down. For example, “Why are Facebook friend requests falling by 10 percent?”

Measure Product/Feature Success - A lot of analytics cases revolve around the measurement of product success and feature changes. For example, “We want to add X feature to product Y. What metrics would you track to make sure that’s a good idea?”

With product data cases, the key difference is that you may or may not be required to write the SQL query to find the metric.

Instead, these interviews are more theoretical and are designed to assess your product sense and ability to think about analytics problems from a product perspective. Product metrics questions may also show up in the data analyst interview , but likely only for product data analyst roles.

Data Analytics Case Study Question: Sample Solution

Let’s start with an example data analytics case question :

You’re given a table that represents search results from searches on Facebook. The query column is the search term, the position column represents each position the search result came in, and the rating column represents the human rating from 1 to 5, where 5 is high relevance, and 1 is low relevance.

Each row in the search_events table represents a single search, with the has_clicked column representing if a user clicked on a result or not. We have a hypothesis that the CTR is dependent on the search result rating.

Write a query to return data to support or disprove this hypothesis.

search_results table:

search_events table

Step 1: With Data Analytics Case Studies, Start by Making Assumptions

Hint: Start by making assumptions and thinking out loud. With this question, focus on coming up with a metric to support the hypothesis. If the question is unclear or if you think you need more information, be sure to ask.

Answer. The hypothesis is that CTR is dependent on search result rating. Therefore, we want to focus on the CTR metric, and we can assume:

• If CTR is high when search result ratings are high, and CTR is low when the search result ratings are low, then the hypothesis is correct.
• If CTR is low when the search ratings are high, or there is no proven correlation between the two, then our hypothesis is not proven.

Step 2: Provide a Solution for the Case Question

Hint: Walk the interviewer through your reasoning. Talking about the decisions you make and why you’re making them shows off your problem-solving approach.

Answer. One way we can investigate the hypothesis is to look at the results split into different search rating buckets. For example, if we measure the CTR for results rated at 1, then those rated at 2, and so on, we can identify if an increase in rating is correlated with an increase in CTR.

First, I’d write a query to get the number of results for each query in each bucket. We want to look at the distribution of results that are less than a rating threshold, which will help us see the relationship between search rating and CTR.

This CTE aggregates the number of results that are less than a certain rating threshold. Later, we can use this to see the percentage that are in each bucket. If we re-join to the search_events table, we can calculate the CTR by then grouping by each bucket.

Step 3: Use Analysis to Backup Your Solution

Hint: Be prepared to justify your solution. Interviewers will follow up with questions about your reasoning, and ask why you make certain assumptions.

Answer. By using the CASE WHEN statement, I calculated each ratings bucket by checking to see if all the search results were less than 1, 2, or 3 by subtracting the total from the number within the bucket and seeing if it equates to 0.

I did that to get away from averages in our bucketing system. Outliers would make it more difficult to measure the effect of bad ratings. For example, if a query had a 1 rating and another had a 5 rating, that would equate to an average of 3. Whereas in my solution, a query with all of the results under 1, 2, or 3 lets us know that it actually has bad ratings.

Product Data Case Question: Sample Solution

In product metrics interviews, you’ll likely be asked about analytics, but the discussion will be more theoretical. You’ll propose a solution to a problem, and supply the metrics you’ll use to investigate or solve it. You may or may not be required to write a SQL query to get those metrics.

We’ll start with an example product metrics case study question :

Let’s say you work for a social media company that has just done a launch in a new city. Looking at weekly metrics, you see a slow decrease in the average number of comments per user from January to March in this city.

The company has been consistently growing new users in the city from January to March.

What are some reasons why the average number of comments per user would be decreasing and what metrics would you look into?

Step 1: Ask Clarifying Questions Specific to the Case

Hint: This question is very vague. It’s all hypothetical, so we don’t know very much about users, what the product is, and how people might be interacting. Be sure you ask questions upfront about the product.

Answer: Before I jump into an answer, I’d like to ask a few questions:

• Who uses this social network? How do they interact with each other?
• Has there been any performance issues that might be causing the problem?
• What are the goals of this particular launch?
• Has there been any changes to the comment features in recent weeks?

For the sake of this example, let’s say we learn that it’s a social network similar to Facebook with a young audience, and the goals of the launch are to grow the user base. Also, there have been no performance issues and the commenting feature hasn’t been changed since launch.

Step 2: Use the Case Question to Make Assumptions

Hint: Look for clues in the question. For example, this case gives you a metric, “average number of comments per user.” Consider if the clue might be helpful in your solution. But be careful, sometimes questions are designed to throw you off track.

Answer: From the question, we can hypothesize a little bit. For example, we know that user count is increasing linearly. That means two things:

• The decreasing comments issue isn’t a result of a declining user base.
• The cause isn’t loss of platform.

We can also model out the data to help us get a better picture of the average number of comments per user metric:

• January: 10000 users, 30000 comments, 3 comments/user
• February: 20000 users, 50000 comments, 2.5 comments/user
• March: 30000 users, 60000 comments, 2 comments/user

One thing to note: Although this is an interesting metric, I’m not sure if it will help us solve this question. For one, average comments per user doesn’t account for churn. We might assume that during the three-month period users are churning off the platform. Let’s say the churn rate is 25% in January, 20% in February and 15% in March.

Step 3: Make a Hypothesis About the Data

Hint: Don’t worry too much about making a correct hypothesis. Instead, interviewers want to get a sense of your product initiation and that you’re on the right track. Also, be prepared to measure your hypothesis.

Answer. I would say that average comments per user isn’t a great metric to use, because it doesn’t reveal insights into what’s really causing this issue.

That’s because it doesn’t account for active users, which are the users who are actually commenting. A better metric to investigate would be retained users and monthly active users.

What I suspect is causing the issue is that active users are commenting frequently and are responsible for the increase in comments month-to-month. New users, on the other hand, aren’t as engaged and aren’t commenting as often.

Step 4: Provide Metrics and Data Analysis

Hint: Within your solution, include key metrics that you’d like to investigate that will help you measure success.

Answer: I’d say there are a few ways we could investigate the cause of this problem, but the one I’d be most interested in would be the engagement of monthly active users.

If the growth in comments is coming from active users, that would help us understand how we’re doing at retaining users. Plus, it will also show if new users are less engaged and commenting less frequently.

One way that we could dig into this would be to segment users by their onboarding date, which would help us to visualize engagement and see how engaged some of our longest-retained users are.

If engagement of new users is the issue, that will give us some options in terms of strategies for addressing the problem. For example, we could test new onboarding or commenting features designed to generate engagement.

Step 5: Propose a Solution for the Case Question

Hint: In the majority of cases, your initial assumptions might be incorrect, or the interviewer might throw you a curveball. Be prepared to make new hypotheses or discuss the pitfalls of your analysis.

Answer. If the cause wasn’t due to a lack of engagement among new users, then I’d want to investigate active users. One potential cause would be active users commenting less. In that case, we’d know that our earliest users were churning out, and that engagement among new users was potentially growing.

Again, I think we’d want to focus on user engagement since the onboarding date. That would help us understand if we were seeing higher levels of churn among active users, and we could start to identify some solutions there.

Tip: Use a Framework to Solve Data Analytics Case Questions

Analytics case questions can be challenging, but they’re much more challenging if you don’t use a framework. Without a framework, it’s easier to get lost in your answer, to get stuck, and really lose the confidence of your interviewer. Find helpful frameworks for data analytics questions in our data analytics learning path and our product metrics learning path .

Once you have the framework down, what’s the best way to practice? Mock interviews with our coaches are very effective, as you’ll get feedback and helpful tips as you answer. You can also learn a lot by practicing P2P mock interviews with other Interview Query students. No data analytics background? Check out how to become a data analyst without a degree .

Finally, if you’re looking for sample data analytics case questions and other types of interview questions, see our guide on the top data analyst interview questions .

Data Analysis Case Studies

• First Online: 23 December 2020

Cite this chapter

• Gayathri Rajagopalan 2  

6910 Accesses

In the last chapter, we looked at the various Python-based visualization libraries and how the functions from these libraries can be used to plot different graphs. Now, we aim to understand the practical applications of the concepts we have discussed so far with the help of case studies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

• Available as PDF
• Read on any device
• Instant download
• Own it forever
• Available as EPUB and PDF
• Compact, lightweight edition
• Dispatched in 3 to 5 business days
• Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Author information

Authors and affiliations.

Bangalore, India

Gayathri Rajagopalan

You can also search for this author in PubMed   Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Gayathri Rajagopalan

About this chapter

Rajagopalan, G. (2021). Data Analysis Case Studies. In: A Python Data Analyst’s Toolkit. Apress, Berkeley, CA. https://doi.org/10.1007/978-1-4842-6399-0_8

Download citation

DOI : https://doi.org/10.1007/978-1-4842-6399-0_8

Published : 23 December 2020

Publisher Name : Apress, Berkeley, CA

Print ISBN : 978-1-4842-6398-3

Online ISBN : 978-1-4842-6399-0

eBook Packages : Professional and Applied Computing Apress Access Books Professional and Applied Computing (R0)

Share this chapter

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Publish with us

Policies and ethics

• Find a journal
• Track your research

The New Equation

Executive leadership hub - What’s important to the C-suite?

Tech Effect

Shared success benefits

Loading Results

No Match Found

Data analytics case study data files

Inventory analysis case study data files:.

Beginning Inventory

Purchase Prices

Vendor Invoices

Ending Inventory

Inventory Analysis Case Study Instructor files:

Instructor guide

Phase 1 - Data Collection and Preparation

Phase 2 - Data Discovery and Visualization

Phase 3 - Introduction to Statistical Analysis

Stay up to date

Subscribe to our University Relations distribution list

Julie Peters

University Relations leader, PwC US

© 2017 - 2024 PwC. All rights reserved. PwC refers to the PwC network and/or one or more of its member firms, each of which is a separate legal entity. Please see www.pwc.com/structure for further details.

• Data Privacy Framework
• Cookie info
• Terms and conditions
• Site provider
• Your Privacy Choices

Next Gen Data Learning – Amplify Your Skills

Data Analytics Case Study Guide 2023

by Enterprise DNA Experts | Data Analytics

Data analytics case studies reveal how businesses harness data for informed decisions and growth.

For aspiring data professionals, mastering the case study process will enhance your skills and increase your career prospects.

So, how do you approach a case study?

Use these steps to process a data analytics case study:

Understand the Problem: Grasp the core problem or question addressed in the case study.

Collect Relevant Data: Gather data from diverse sources, ensuring accuracy and completeness.

Apply Analytical Techniques: Use appropriate methods aligned with the problem statement.

Visualize Insights: Utilize visual aids to showcase patterns and key findings.

Derive Actionable Insights: Focus on deriving meaningful actions from the analysis.

This article will give you detailed steps to navigate a case study effectively and understand how it works in real-world situations.

By the end of the article, you will be better equipped to approach a data analytics case study, strengthening your analytical prowess and practical application skills.

Let’s dive in!

Table of Contents

What is a Data Analytics Case Study?

A data analytics case study is a real or hypothetical scenario where analytics techniques are applied to solve a specific problem or explore a particular question.

It’s a practical approach that uses data analytics methods, assisting in deciphering data for meaningful insights. This structured method helps individuals or organizations make sense of data effectively.

Additionally, it’s a way to learn by doing, where there’s no single right or wrong answer in how you analyze the data.

So, what are the components of a case study?

Key Components of a Data Analytics Case Study

A data analytics case study comprises essential elements that structure the analytical journey:

Problem Context: A case study begins with a defined problem or question. It provides the context for the data analysis , setting the stage for exploration and investigation.

Data Collection and Sources: It involves gathering relevant data from various sources , ensuring data accuracy, completeness, and relevance to the problem at hand.

Analysis Techniques: Case studies employ different analytical methods, such as statistical analysis, machine learning algorithms, or visualization tools, to derive meaningful conclusions from the collected data.

Insights and Recommendations: The ultimate goal is to extract actionable insights from the analyzed data, offering recommendations or solutions that address the initial problem or question.

Now that you have a better understanding of what a data analytics case study is, let’s talk about why we need and use them.

Why Case Studies are Integral to Data Analytics

Case studies serve as invaluable tools in the realm of data analytics, offering multifaceted benefits that bolster an analyst’s proficiency and impact:

Real-Life Insights and Skill Enhancement: Examining case studies provides practical, real-life examples that expand knowledge and refine skills. These examples offer insights into diverse scenarios, aiding in a data analyst’s growth and expertise development.

Validation and Refinement of Analyses: Case studies demonstrate the effectiveness of data-driven decisions across industries, providing validation for analytical approaches. They showcase how organizations benefit from data analytics. Also, this helps in refining one’s own methodologies

Showcasing Data Impact on Business Outcomes: These studies show how data analytics directly affects business results, like increasing revenue, reducing costs, or delivering other measurable advantages. Understanding these impacts helps articulate the value of data analytics to stakeholders and decision-makers.

Learning from Successes and Failures: By exploring a case study, analysts glean insights from others’ successes and failures, acquiring new strategies and best practices. This learning experience facilitates professional growth and the adoption of innovative approaches within their own data analytics work.

Including case studies in a data analyst’s toolkit helps gain more knowledge, improve skills, and understand how data analytics affects different industries.

Using these real-life examples boosts confidence and success, guiding analysts to make better and more impactful decisions in their organizations.

But not all case studies are the same.

Let’s talk about the different types.

Types of Data Analytics Case Studies

Data analytics encompasses various approaches tailored to different analytical goals:

Exploratory Case Study: These involve delving into new datasets to uncover hidden patterns and relationships, often without a predefined hypothesis. They aim to gain insights and generate hypotheses for further investigation.

Predictive Case Study: These utilize historical data to forecast future trends, behaviors, or outcomes. By applying predictive models, they help anticipate potential scenarios or developments.

Diagnostic Case Study: This type focuses on understanding the root causes or reasons behind specific events or trends observed in the data. It digs deep into the data to provide explanations for occurrences.

Prescriptive Case Study: This case study goes beyond analytics; it provides actionable recommendations or strategies derived from the analyzed data. They guide decision-making processes by suggesting optimal courses of action based on insights gained.

Each type has a specific role in using data to find important insights, helping in decision-making, and solving problems in various situations.

Regardless of the type of case study you encounter, here are some steps to help you process them.

Roadmap to Handling a Data Analysis Case Study

Embarking on a data analytics case study requires a systematic approach, step-by-step, to derive valuable insights effectively.

Here are the steps to help you through the process:

Step 1: Understanding the Case Study Context: Immerse yourself in the intricacies of the case study. Delve into the industry context, understanding its nuances, challenges, and opportunities.

Identify the central problem or question the study aims to address. Clarify the objectives and expected outcomes, ensuring a clear understanding before diving into data analytics.

Step 2: Data Collection and Validation: Gather data from diverse sources relevant to the case study. Prioritize accuracy, completeness, and reliability during data collection. Conduct thorough validation processes to rectify inconsistencies, ensuring high-quality and trustworthy data for subsequent analysis.

Step 3: Problem Definition and Scope: Define the problem statement precisely. Articulate the objectives and limitations that shape the scope of your analysis. Identify influential variables and constraints, providing a focused framework to guide your exploration.

Step 4: Exploratory Data Analysis (EDA): Leverage exploratory techniques to gain initial insights. Visualize data distributions, patterns, and correlations, fostering a deeper understanding of the dataset. These explorations serve as a foundation for more nuanced analysis.

Step 5: Data Preprocessing and Transformation: Cleanse and preprocess the data to eliminate noise, handle missing values, and ensure consistency. Transform data formats or scales as required, preparing the dataset for further analysis.

Step 6: Data Modeling and Method Selection: Select analytical models aligning with the case study’s problem, employing statistical techniques, machine learning algorithms, or tailored predictive models.

In this phase, it’s important to develop data modeling skills. This helps create visuals of complex systems using organized data, which helps solve business problems more effectively.

Understand key data modeling concepts, utilize essential tools like SQL for database interaction, and practice building models from real-world scenarios.

Furthermore, strengthen data cleaning skills for accurate datasets, and stay updated with industry trends to ensure relevance.

Step 7: Model Evaluation and Refinement: Evaluate the performance of applied models rigorously. Iterate and refine models to enhance accuracy and reliability, ensuring alignment with the objectives and expected outcomes.

Step 8: Deriving Insights and Recommendations: Extract actionable insights from the analyzed data. Develop well-structured recommendations or solutions based on the insights uncovered, addressing the core problem or question effectively.

Step 9: Communicating Results Effectively: Present findings, insights, and recommendations clearly and concisely. Utilize visualizations and storytelling techniques to convey complex information compellingly, ensuring comprehension by stakeholders.

Step 10: Reflection and Iteration: Reflect on the entire analysis process and outcomes. Identify potential improvements and lessons learned. Embrace an iterative approach, refining methodologies for continuous enhancement and future analyses.

This step-by-step roadmap provides a structured framework for thorough and effective handling of a data analytics case study.

Now, after handling data analytics comes a crucial step; presenting the case study.

Presenting Your Data Analytics Case Study

Presenting a data analytics case study is a vital part of the process. When presenting your case study, clarity and organization are paramount.

To achieve this, follow these key steps:

Structuring Your Case Study: Start by outlining relevant and accurate main points. Ensure these points align with the problem addressed and the methodologies used in your analysis.

Crafting a Narrative with Data: Start with a brief overview of the issue, then explain your method and steps, covering data collection, cleaning, stats, and advanced modeling.

Visual Representation for Clarity: Utilize various visual aids—tables, graphs, and charts—to illustrate patterns, trends, and insights. Ensure these visuals are easy to comprehend and seamlessly support your narrative.

Highlighting Key Information: Use bullet points to emphasize essential information, maintaining clarity and allowing the audience to grasp key takeaways effortlessly. Bold key terms or phrases to draw attention and reinforce important points.

Addressing Audience Queries: Anticipate and be ready to answer audience questions regarding methods, assumptions, and results. Demonstrating a profound understanding of your analysis instills confidence in your work.

Integrity and Confidence in Delivery: Maintain a neutral tone and avoid exaggerated claims about findings. Present your case study with integrity, clarity, and confidence to ensure the audience appreciates and comprehends the significance of your work.

By organizing your presentation well, telling a clear story through your analysis, and using visuals wisely, you can effectively share your data analytics case study.

This method helps people understand better, stay engaged, and draw valuable conclusions from your work.

We hope by now, you are feeling very confident processing a case study. But with any process, there are challenges you may encounter.

Key Challenges in Data Analytics Case Studies

A data analytics case study can present various hurdles that necessitate strategic approaches for successful navigation:

Challenge 1: Data Quality and Consistency

Challenge: Inconsistent or poor-quality data can impede analysis, leading to erroneous insights and flawed conclusions.

Solution: Implement rigorous data validation processes, ensuring accuracy, completeness, and reliability. Employ data cleansing techniques to rectify inconsistencies and enhance overall data quality.

Challenge 2: Complexity and Scale of Data

Challenge: Managing vast volumes of data with diverse formats and complexities poses analytical challenges.

Solution: Utilize scalable data processing frameworks and tools capable of handling diverse data types. Implement efficient data storage and retrieval systems to manage large-scale datasets effectively.

Challenge 3: Interpretation and Contextual Understanding

Challenge: Interpreting data without contextual understanding or domain expertise can lead to misinterpretations.

Solution: Collaborate with domain experts to contextualize data and derive relevant insights. Invest in understanding the nuances of the industry or domain under analysis to ensure accurate interpretations.

Challenge 4: Privacy and Ethical Concerns

Challenge: Balancing data access for analysis while respecting privacy and ethical boundaries poses a challenge.

Solution: Implement robust data governance frameworks that prioritize data privacy and ethical considerations. Ensure compliance with regulatory standards and ethical guidelines throughout the analysis process.

Challenge 5: Resource Limitations and Time Constraints

Challenge: Limited resources and time constraints hinder comprehensive analysis and exhaustive data exploration.

Solution: Prioritize key objectives and allocate resources efficiently. Employ agile methodologies to iteratively analyze and derive insights, focusing on the most impactful aspects within the given timeframe.

Recognizing these challenges is key; it helps data analysts adopt proactive strategies to mitigate obstacles. This enhances the effectiveness and reliability of insights derived from a data analytics case study.

Now, let’s talk about the best software tools you should use when working with case studies.

Top 5 Software Tools for Case Studies

In the realm of case studies within data analytics, leveraging the right software tools is essential.

Here are some top-notch options:

Tableau : Renowned for its data visualization prowess, Tableau transforms raw data into interactive, visually compelling representations, ideal for presenting insights within a case study.

Python and R Libraries: These flexible programming languages provide many tools for handling data, doing statistics, and working with machine learning, meeting various needs in case studies.

Microsoft Excel : A staple tool for data analytics, Excel provides a user-friendly interface for basic analytics, making it useful for initial data exploration in a case study.

SQL Databases : Structured Query Language (SQL) databases assist in managing and querying large datasets, essential for organizing case study data effectively.

Statistical Software (e.g., SPSS , SAS ): Specialized statistical software enables in-depth statistical analysis, aiding in deriving precise insights from case study data.

Choosing the best mix of these tools, tailored to each case study’s needs, greatly boosts analytical abilities and results in data analytics.

Final Thoughts

Case studies in data analytics are helpful guides. They give real-world insights, improve skills, and show how data-driven decisions work.

Using case studies helps analysts learn, be creative, and make essential decisions confidently in their data work.

Check out our latest clip below to further your learning!

Frequently Asked Questions

What are the key steps to analyzing a data analytics case study.

When analyzing a case study, you should follow these steps:

Clarify the problem : Ensure you thoroughly understand the problem statement and the scope of the analysis.

Make assumptions : Define your assumptions to establish a feasible framework for analyzing the case.

Gather context : Acquire relevant information and context to support your analysis.

Analyze the data : Perform calculations, create visualizations, and conduct statistical analysis on the data.

Provide insights : Draw conclusions and develop actionable insights based on your analysis.

How can you effectively interpret results during a data scientist case study job interview?

During your next data science interview, interpret case study results succinctly and clearly. Utilize visual aids and numerical data to bolster your explanations, ensuring comprehension.

Frame the results in an audience-friendly manner, emphasizing relevance. Concentrate on deriving insights and actionable steps from the outcomes.

How do you showcase your data analyst skills in a project?

To demonstrate your skills effectively, consider these essential steps. Begin by selecting a problem that allows you to exhibit your capacity to handle real-world challenges through analysis.

Methodically document each phase, encompassing data cleaning, visualization, statistical analysis, and the interpretation of findings.

Utilize descriptive analysis techniques and effectively communicate your insights using clear visual aids and straightforward language. Ensure your project code is well-structured, with detailed comments and documentation, showcasing your proficiency in handling data in an organized manner.

Lastly, emphasize your expertise in SQL queries, programming languages, and various analytics tools throughout the project. These steps collectively highlight your competence and proficiency as a skilled data analyst, demonstrating your capabilities within the project.

Can you provide an example of a successful data analytics project using key metrics?

A prime illustration is utilizing analytics in healthcare to forecast hospital readmissions. Analysts leverage electronic health records, patient demographics, and clinical data to identify high-risk individuals.

Implementing preventive measures based on these key metrics helps curtail readmission rates, enhancing patient outcomes and cutting healthcare expenses.

This demonstrates how data analytics, driven by metrics, effectively tackles real-world challenges, yielding impactful solutions.

Why would a company invest in data analytics?

Companies invest in data analytics to gain valuable insights, enabling informed decision-making and strategic planning. This investment helps optimize operations, understand customer behavior, and stay competitive in their industry.

Ultimately, leveraging data analytics empowers companies to make smarter, data-driven choices, leading to enhanced efficiency, innovation, and growth.

Related Posts

The Importance of Data Analytics in Today’s World

Data Analytics , Power BI

In today’s data-driven world, the role of data analytics has never been more crucial. Data analytics is...

4 Types of Data Analytics: Explained

Data Analytics

In a world full of data, data analytics is the heart and soul of an operation. It's what transforms raw...

FOR EMPLOYERS

Top 10 real-world data science case studies.

Aditya Sharma

Aditya is a content writer with 5+ years of experience writing for various industries including Marketing, SaaS, B2B, IT, and Edtech among others. You can find him watching anime or playing games when he’s not writing.

Frequently Asked Questions

Real-world data science case studies differ significantly from academic examples. While academic exercises often feature clean, well-structured data and simplified scenarios, real-world projects tackle messy, diverse data sources with practical constraints and genuine business objectives. These case studies reflect the complexities data scientists face when translating data into actionable insights in the corporate world.

Real-world data science projects come with common challenges. Data quality issues, including missing or inaccurate data, can hinder analysis. Domain expertise gaps may result in misinterpretation of results. Resource constraints might limit project scope or access to necessary tools and talent. Ethical considerations, like privacy and bias, demand careful handling.

Lastly, as data and business needs evolve, data science projects must adapt and stay relevant, posing an ongoing challenge.

Real-world data science case studies play a crucial role in helping companies make informed decisions. By analyzing their own data, businesses gain valuable insights into customer behavior, market trends, and operational efficiencies.

These insights empower data-driven strategies, aiding in more effective resource allocation, product development, and marketing efforts. Ultimately, case studies bridge the gap between data science and business decision-making, enhancing a company's ability to thrive in a competitive landscape.

Key takeaways from these case studies for organizations include the importance of cultivating a data-driven culture that values evidence-based decision-making. Investing in robust data infrastructure is essential to support data initiatives. Collaborating closely between data scientists and domain experts ensures that insights align with business goals.

Finally, continuous monitoring and refinement of data solutions are critical for maintaining relevance and effectiveness in a dynamic business environment. Embracing these principles can lead to tangible benefits and sustainable success in real-world data science endeavors.

Data science is a powerful driver of innovation and problem-solving across diverse industries. By harnessing data, organizations can uncover hidden patterns, automate repetitive tasks, optimize operations, and make informed decisions.

In healthcare, for example, data-driven diagnostics and treatment plans improve patient outcomes. In finance, predictive analytics enhances risk management. In transportation, route optimization reduces costs and emissions. Data science empowers industries to innovate and solve complex challenges in ways that were previously unimaginable.

Hire remote developers

Tell us the skills you need and we'll find the best developer for you in days, not weeks.

• Open access
• Published: 23 September 2023

Educational interventions targeting pregnant women to optimise the use of caesarean section: What are the essential elements? A qualitative comparative analysis

• Rana Islamiah Zahroh   ORCID: orcid.org/0000-0001-7831-2336 1 ,
• Katy Sutcliffe   ORCID: orcid.org/0000-0002-5469-8649 2 ,
• Dylan Kneale   ORCID: orcid.org/0000-0002-7016-978X 2 ,
• Martha Vazquez Corona   ORCID: orcid.org/0000-0003-2061-9540 1 ,
• Ana Pilar Betrán   ORCID: orcid.org/0000-0002-5631-5883 3 ,
• Newton Opiyo   ORCID: orcid.org/0000-0003-2709-3609 3 ,
• Caroline S. E. Homer   ORCID: orcid.org/0000-0002-7454-3011 4 &
• Meghan A. Bohren   ORCID: orcid.org/0000-0002-4179-4682 1  

BMC Public Health volume  23 , Article number:  1851 ( 2023 ) Cite this article

1219 Accesses

1 Citations

1 Altmetric

Metrics details

Caesarean section (CS) rates are increasing globally, posing risks to women and babies. To reduce CS, educational interventions targeting pregnant women have been implemented globally, however, their effectiveness is varied. To optimise benefits of these interventions, it is important to understand which intervention components influence success. In this study, we aimed to identify essential intervention components that lead to successful implementation of interventions focusing on pregnant women to optimise CS use.

We re-analysed existing systematic reviews that were used to develop and update WHO guidelines on non-clinical interventions to optimise CS. To identify if certain combinations of intervention components (e.g., how the intervention was delivered, and contextual characteristics) are associated with successful implementation, we conducted a Qualitative Comparative Analysis (QCA). We defined successful interventions as interventions that were able to reduce CS rates. We included 36 papers, comprising 17 CS intervention studies and an additional 19 sibling studies (e.g., secondary analyses, process evaluations) reporting on these interventions to identify intervention components. We conducted QCA in six stages: 1) Identifying conditions and calibrating the data; 2) Constructing truth tables, 3) Checking quality of truth tables; 4) Identifying parsimonious configurations through Boolean minimization; 5) Checking quality of the solution; 6) Interpretation of solutions. We used existing published qualitative evidence synthesis to develop potential theories driving intervention success.

We found successful interventions were those that leveraged social or peer support through group-based intervention delivery, provided communication materials to women, encouraged emotional support by partner or family participation, and gave women opportunities to interact with health providers. Unsuccessful interventions were characterised by the absence of at least two of these components.

We identified four key essential intervention components which can lead to successful interventions targeting women to reduce CS. These four components are 1) group-based delivery, 2) provision of IEC materials, 3) partner or family member involvement, and 4) opportunity for women to interact with health providers. Maternal health services and hospitals aiming to better prepare women for vaginal birth and reduce CS can consider including the identified components to optimise health and well-being benefits for the woman and baby.

Peer Review reports

Introduction

In recent years, caesarean section (CS) rates have increased globally [ 1 , 2 , 3 , 4 ]. CS can be a life-saving procedure when vaginal birth is not possible; however, it comes with higher risks both in the short- and long-term for women and babies [ 1 , 5 ]. Women with CS have increased risks of surgical complications, complications in future pregnancies, subfertility, bowel obstruction, and chronic pain [ 5 , 6 , 7 , 8 ]. Similarly, babies born through CS have increased risks of hypoglycaemia, respiratory problems, allergies and altered immunity [ 9 , 10 , 11 ]. At a population level, CS rates exceeding 15% are unlikely to reduce mortality rates [ 1 , 12 ]. Despite these risks, an analysis across 154 countries reported a global average CS rate of 21.1% in 2018, projected to increase to 28.5% by 2030 [ 3 ].

There are many reasons for the increasing CS rates, and these vary between and within countries. Increasingly, non-clinical factors across different societal dimensions and stakeholders (e.g. women and communities, health providers, and health systems) are contributing to this increase [ 13 , 14 , 15 , 16 , 17 ]. Women may prefer CS over vaginal birth due to fear of labour or vaginal birth, previous negative experience of childbirth, perceived increased risks of vaginal birth, beliefs about an auspicious or convenient day of birth, or beliefs that caesarean section is safer, quick, and painless compared to vaginal birth [ 13 , 14 , 15 ].

Interventions targeting pregnant women to reduce CS have been implemented globally. A Cochrane intervention review synthesized evidence from non-clinical interventions targeting pregnant women and family, providers, and health systems to reduce unnecessary CS, and identified 15 interventions targeting women [ 18 ]. Interventions targeting women primarily focused on improving women’s knowledge around birth, improving women’s ability to cope during labour, and decreasing women’s stress related to labour through childbirth education, and decision aids for women with previous CS [ 18 ]. These types of interventions aim to reduce the concerns of pregnant women and their partners around childbirth, and prepare them for vaginal birth.

The effectiveness of interventions targeting women in reducing CS is mixed [ 18 , 19 ]. Plausible explanations for this limited success include the multifactorial nature of the factors driving increases in CS, as well as the contextual characteristics of the interventions, which may include the study environment, participant characteristics, intensity of exposure to the intervention and method of implementation. Understanding which intervention components are essential influencers of the success of the interventions is conducive to optimising benefits. This study used a Qualitative Comparative Analysis (QCA) approach to re-analyse evidence from existing systematic reviews to identify essential intervention components that lead to the successful implementation of non-clinical interventions focusing on pregnant women to optimise the use of CS. Updating and re-analysing existing systematic reviews using new analytical frameworks may help to explore the heterogeneity in effects and ascertain why some studies appear to be effective while others are not.

Data sources, case selection, and defining outcomes

Developing a logic model.

We developed a logic model to guide our understanding of different pathways and intervention components potentially leading to successful implementation (Additional file 1 ). The logic model was developed based on published qualitative evidence syntheses and systematic reviews [ 18 , 20 , 21 , 22 , 23 , 24 ]. The logic model depicts the desired outcome of reduced CS rates in low-risk women (at the time of admission for birth, these women are typically represented by Robson groups 1–4 [ 25 ] and are women with term, cephalic, singleton pregnancies without a previous CS) and works backwards to understand what inputs and processes are needed to achieve the desired outcome. Our logic model shows multiple pathways to success and highlights the interactions between different levels of factors (women, providers, societal, health system) (Additional file 1 ). Based on the logic model, we have separated our QCA into two clusters of interventions: 1) interventions targeting women, and 2) interventions targeting health providers. The results of analysis on interventions targeting health providers have been published elsewhere [ 26 ]. The logic model was also used to inform the potential important components that influence success.

Identifying data sources and selecting cases

We re-analysed the systematic reviews which were used to inform the development and update of World Health Organization (WHO) guidelines. In 2018, WHO issued global guidance on non-clinical interventions to reduce unnecessary CS, with interventions designed to target three different levels or stakeholders: women, health providers, and health systems [ 27 ]. As part of the guideline recommendations, a series of systematic reviews about CS interventions were conducted: 1) a Cochrane intervention review of effectiveness by Chen et al. (2018) [ 18 ] and 2) three qualitative evidence syntheses exploring key stakeholder perspectives and experiences of interventions focusing on women and communities, health professionals, and health organisations, facilities and systems by Kingdon et al. (2018) [ 20 , 21 , 22 ]. Later on, Opiyo and colleagues (2020) published a scoping review of financial and regulatory interventions to optimise the use of CS [ 23 ].

Therefore, the primary data sources of this QCA are the intervention studies included in Chen et al. (2018) [ 18 ] and Opiyo et al. (2020) [ 23 ]. We used these two systematic reviews as not only they are comprehensive, but they were also used to inform the WHO guidelines development. A single intervention study is referred to as a “case”. Eligible cases were intervention studies focusing on pregnant women and aimed to reduce or optimise the use of CS. No restrictions on study design were imposed in the QCA. Therefore, we also assessed the eligibility of intervention studies excluded from Chen et al. (2018) [ 18 ] and Opiyo et al. (2020) [ 23 ] due to ineligible study designs (such as cohort study, uncontrolled before and after study, interrupted time series with fewer than three data points), as these studies could potentially show other pathways to successful implementation. We complemented these intervention studies with additional intervention studies published since the last review updates in 2018 and 2020, to include intervention studies that are likely to meet the review inclusion criteria for future review updates. No further search was conducted as QCA is suitable for medium-N cases, approximately around 10–50 cases, and inclusion of more studies may threaten study rigour [ 28 ].

Once eligible studies were selected, we searched for their ‘sibling studies’. Sibling studies are studies linked to the included intervention studies, such as formative research or process evaluations which may have been published separately. Sibling studies can provide valuable additional information about study context, intervention components, and implementation outcomes (e.g. acceptability, fidelity, adherence, dosage), which may not be well described in a single article about intervention effectiveness. We searched for sibling studies using the following steps: 1) reference list search of the intervention studies included in Chen et al. (2018) [ 18 ] and Opiyo et al. (2020) [ 23 ], 2) reference list search of the qualitative studies included in Kingdon et al. (2018) reviews [ 20 , 21 , 22 ]; and 3) forward reference search of the intervention studies (through “Cited by” function) in Scopus and Web of Science. Sibling studies were included if they included any information on intervention components or implementation outcomes, regardless of the methodology used. One author conducted the study screening independently (RIZ), and 10% of the screening was double-checked by a second author (MAB). Disagreements during screening were discussed until consensus, and with the rest of the author team if needed.

Defining outcomes

We assessed all outcomes related to the mode of birth in the studies included in the Chen et al. (2018) [ 18 ] and Opiyo et al. (2020) [ 23 ] reviews. Based on the consistency of outcome reporting, we selected “overall CS rate” as the primary outcome of interest due to its presence across studies. We planned to rank the rate ratio across these studies to select the 10 most successful and unsuccessful intervention studies. However, due to heterogeneity in how CS outcomes were reported across studies (e.g. odds ratios, rate ratios, percentages across different intervention stages), the final categorisation of successful or unsuccessful interventions is based on whether the CS rate decreased, based on the precision of the confidence interval or p-value (successful, coded as 1), or CS rate increased or did not change (unsuccessful, coded as 0).

Assessing risk of bias in intervention studies

All intervention studies eligible for inclusion were assessed for risk of bias. All studies included in Chen et al. (2018) and Opiyo et al. (2020) already had risk of bias assessed and reported [ 18 , 23 ], and we used these assessments. Additional intervention studies outside the included studies on these reviews were assessed using the same tools depending on the type of evidence (two randomized controlled trials and one uncontrolled before and after study), and details of the risk of bias assessment results can be found in Additional file 2 . We excluded studies with a high risk of bias to ensure that the analysis was based on high-quality studies and to enhance the ability of researchers to develop deep case knowledge by limiting the overall number of studies.

Qualitative comparative analysis (QCA)

QCA was first developed and used in political sciences and has since been extended to systematic reviews of complex health interventions [ 24 , 29 , 30 , 31 ]. Despite the term “qualitative”, QCA is not a typical qualitative analysis, and is often conceptualised as a methodology that bridges qualitative and quantitative methodologies based on its process, data used and theoretical standpoint [ 24 ]. Here, QCA is used to identify if certain configurations or combinations of intervention components (e.g. participants, types of interventions, contextual characteristics, and intervention delivery) are associated with the desired outcome [ 31 ]. These intervention components are referred to as “conditions” in the QCA methodology. Whilst statistical synthesis methods may be used to examine intervention heterogeneity in systematic reviews, such as meta-regression, QCA is a particularly suitable method to understand complex interventions like those aiming to optimise CS, as it allows for multiple overlapping pathways to causality [ 31 ]. Moreover, QCA allows the exploration of different combinations of conditions, rather than relying on a single condition leading to intervention effectiveness [ 31 ]. Although meta-regression allows for the assessment of multiple conditions, a sufficient number of studies may not be available to conduct the analysis. In complex interventions, such as interventions aiming to optimise the use of CS, single condition or standard meta-analysis may be less likely to yield usable and nuanced information about what intervention components are more or less likely to yield success [ 31 ].

QCA uses ‘set theory’ to systematically compare characteristics of the cases (e.g. intervention in the case of systematic reviews) in relation to the outcomes [ 31 , 32 ]. This means QCA compares the characteristics of the successful ‘cases’ (e.g. interventions that are effective) to those unsuccessful ‘cases’ (e.g. interventions that are not effective). The comparison is conducted using a scoring system based on ‘set membership’ [ 31 , 32 ]. In this scoring, conditions and outcomes are coded based on the extent to which a certain feature is present or absent to form set membership scores [ 31 , 32 ]. There are two scoring systems in QCA: 1) crisp set QCA (csQCA) and 2) fuzzy set QCA (fsQCA). csQCA assigns binary scores of 0 (“fully out” to set membership for cases with certain conditions) and 1 (“fully in” to set membership for cases with certain conditions), while fsQCA assigns ordinal scoring of conditions and outcomes, permitting partial membership scores between 0 and 1 [ 31 , 32 ]. For example, using fsQCA we may assign a five-level scoring system (0, 0.33, 0.5, 0.67, 1), where 0.33 would indicate “more out” than “in” to the set of membership, and 0.67 would indicate “more in” than “out”, and 0.5 would indicate ambiguity (i.e. a lack of information about whether a case was “in” or “out”) [ 31 , 32 ]. In our analysis, we used the combination of both csQCA and fsQCA to calibrate our data. This approach was necessary because some conditions were better suited to binary options using csQCA, while others were more complex, depending on the distribution of cases, and required fsQCA to capture the necessary information. In our final analysis, however, the conditions run on the final analysis were all using the csQCA scoring system.

Two relationships can be investigated using QCA [ 24 , 31 ]. First, if all instances of successful interventions share the same condition(s), this suggests these features are ‘necessary’ to trigger successful outcomes [ 24 , 31 ]. Second, if all instances of a particular condition are associated with successful interventions, this suggests these conditions are ‘sufficient’ for triggering successful outcomes [ 24 , 31 ]. In this QCA, we were interested to explore the relationship of sufficiency: that is, to assess the various combinations of intervention components that can trigger successful outcomes. We were interested in sufficiency because our logic model (explained further below) highlighted the multiple pathways that can lead to a CS and different interventions that may optimise the use of CS along those pathways, which suggested that it would be unlikely for all successful interventions to share the same conditions. We calculated the degree of sufficiency using consistency measures, which evaluate the frequency in which conditions are present when the desired outcome is achieved [ 31 , 32 ]. The conditions with a consistency score of at least 0.8 were considered sufficient in triggering successful interventions [ 31 , 32 ]. At present, there is no tool available for reporting guidelines in the re-analysis of systematic reviews using QCA, however, CARU-QCA is currently being developed for this purpose [ 33 ]. QCA was conducted using R programming software with a package developed by Thiem & Duşa (2013) and QCA with R guidebook [ 32 ]. QCA was conducted in six stages based on Thomas et al. (2014) [ 31 ] and explained below.

QCA stage 1: Identifying conditions, building data tables and calibration

We used a deductive and inductive process to determine the potential conditions (intervention components) that may trigger successful implementation. Conditions were first derived deductively using the developed logic model (Additional file 1 ). We then added additional conditions inductively using Intervention Component Analysis from the intervention studies [ 34 ], and qualitative evidence (“view”) synthesis [ 22 ] using Melendez-Torres’s (2018) approach [ 35 ]. Intervention Component Analysis is a methodological approach that examines factors affecting implementation through reflections from the trialist, which is typically presented in the discussion section of a published trial [ 34 ]. Examples of conditions identified in the Intervention Component Analysis include using an individualised approach, interaction with health providers, policies that encourage CS and acknowledgement of women’s previous birth experiences. After consolidating or merging similar conditions, a total of 52 conditions were selected and extracted from each included intervention and analysed in this QCA (Details of conditions and definitions generated for this study can be found in Additional files 3 and 4 ). We adapted the coding framework from Harris et al. (2019) [ 24 ] by adapting coding rules and six domains that were used, to organize the 52 conditions and make more sense of the data. These six domains are broadly classified as 1) context and participants, 2) intervention design, 3) program content, 4) method of engagement, 5) health system factors, and 6) process outcomes.

One author (RIZ) extracted data relevant to the conditions for each included study into a data table, which was then double-reviewed by two other authors (MVC, MAB). The data table is a matrix in which each case is represented in a row, and columns are used to represent the conditions. Following data extraction, calibration rules using either csQCA or fsQCA (e.g. group-based intervention delivery condition: yes = 1 (present), no = 0 (absent)) were developed through consultation with all authors. We developed a table listing the conditions and rules of coding the conditions, by either direct or transformational assignment of quantitative and qualitative data [ 24 , 32 ] (Additional file 3 depicts the calibration rules). The data tables were then calibrated by applying scores, to explore the extent to which interventions have ‘set membership’ with the outcome or conditions of interest. During this iterative process, the calibration criteria were explicitly defined, emerging from the literature and the cases themselves. It is important to note, that maximum ambiguity is typically scored as 0.5 in QCA, however, we decided it would be more appropriate to assume that if a condition was not reported it was unlikely to be a feature of the intervention, so we treated not reported as “absence” that is we coded it 0.

QCA stage 2: Constructing truth tables

Truth tables are an analytical tool used in QCA to analyse associations between configurations of conditions and outcomes. Whereas the data table represents individual cases (rows) and individual conditions (columns) – the truth table synthesises this data to examine configurations – with each row representing a different configuration of the conditions. The columns indicate a) which conditions are featured in the configuration in that row, b) how many of the cases are represented by that configuration, and c) their association with the outcome.

We first constructed the truth tables based on context and participants, intervention designs, program content, and method of engagement; however, no configurations to trigger successful interventions were observed. Instead, we observed limited diversity, meaning there were many instances in which the configurations were unsupported by cases, likely due to the presence of too many conditions in the truth tables. We used the learning from these truth tables to return to the literature to explore potential explanatory theories about what conditions are important from the perspectives of participants and trialists to trigger successful interventions (adhering to the ‘utilisation of view’ perspective [ 35 ]). Through this process, we found that women and communities liked to learn new information about childbirth, and desired emotional support from partners and health providers while learning [ 22 ]. They also appreciated educational interventions that provide opportunities for discussion and dialogue with health providers and align with current clinical practice and advice from health providers [ 22 ]. Therefore, three models of truth tables were iteratively constructed and developed based on three important hypothesised theories about how the interventions should be delivered: 1) how birth information was provided to women, 2) emotional support was provided to women (including interactions between women and providers), and 3) a consolidated model examining the interactions of important conditions identified from model 1 and 2. We also conducted a sub-analysis of interventions targeting both women and health providers or systems (‘multi-target interventions’). This sub-analysis was conducted to explore if similar conditions were observed in triggering successful interventions in multi-target interventions, among the components for women only. Table 1 presents the list of truth tables that were iteratively constructed and refined.

QCA stage 3: Checking quality of truth tables

We iteratively developed and improved the quality of truth tables by checking the configurations of successful and unsuccessful interventions, as recommended by Thomas et al. (2014) [ 31 ]. This includes by assessing the number of studies clustering to each configuration, and exploring the presence of any contradictory results between successful and unsuccessful interventions. We found contradictory configurations across the five truth tables, which were resolved by considering the theoretical perspectives and iteratively refining the truth tables.

QCA stage 4: Identifying parsimonious configurations through Boolean minimization

Once we determined that the truth tables were suitable for further analysis, we used Boolean minimisation to explore pathways resulting in successful intervention through the configurations of different conditions [ 31 ]. We simplified the “complex solution” of the pathways to a “parsimonious solution” and an “intermediate solution” by incorporating logical remainders (configurations where no cases were observed) [ 36 ].

QCA stage 5: Checking the quality of the solution

We presented the intermediate solution as the final solution instead of the most parsimonious solution, as it is most closely aligned with the underlying theory. We checked consistency and coverage scores to assess if the pathways identified were sufficient to trigger success. We also checked the intermediate solution by negating the outcome to see if it predicts the observed solutions.

QCA stage 6: Interpretation of solutions

We iteratively interpreted the results of the findings through discussions among the QCA team. This reflexive approach ensured that the results of the analysis considered the perspectives from the literature discourse, methodological approach, and that the results were coherent with the current understanding of the phenomenon.

Overview of included studies

Out of 79 intervention studies assessed by Chen et al. (2018) [ 18 ] and Opiyo et al. (2020) [ 23 ], 17 intervention studies targeted women and are included, comprising 11 interventions targeting only women [ 37 , 38 , 39 , 40 , 41 , 42 , 43 ] and six interventions targeting both women and health providers or systems [ 44 , 45 , 46 , 47 , 48 , 49 ]. From 17 included studies, 19 sibling studies were identified [ 43 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 ]. Thus, a total of 36 papers from 17 intervention studies are included in this QCA (See Fig.  1 : PRISMA Flowchart).

PRISMA flowchart. *Sibling studies: studies that were conducted in the same settings, participants, and timeframe; **Intervention components: information on intervention input, activities, and outputs, including intervention context and other characteristics

The 11 interventions targeting women comprised of five successful interventions [ 37 , 68 , 69 , 70 , 71 ] and six unsuccessful interventions [ 37 , 38 , 39 , 40 , 41 , 42 , 43 ] in reducing CS. Sixteen sibling studies were identified, from five out of 11 included interventions [ 37 , 41 , 43 , 70 , 71 ]. Included studies were conducted in six countries across North America (2 from Canada [ 38 ] and 1 from United States of America [ 71 ]), Asia–Pacific (1 from Australia [ 41 ]), 5 from Iran [ 39 , 40 , 68 , 69 , 70 ]), Europe (2 from Finland [ 37 , 42 ], 1 from United Kingdom [ 43 ]). Six studies were conducted in high-income countries, while five studies were conducted in upper-middle-income countries (all from Iran). All 11 studies targeted women, with three studies also explicitly targeting women’s partners [ 68 , 69 , 71 ]. One study delivering psychoeducation allowed women to bring any family members to accompany them during the intervention but did not specifically target partners [ 37 ]. All 11 studies delivered childbirth education, with four delivering general antenatal education [ 38 , 40 , 68 , 69 ], six delivering psychoeducation [ 37 , 39 , 41 , 42 , 70 , 71 ], and one implementing decision aids [ 43 ]. All studies were included in Chen et al. (2018), and some risks of bias were identified [ 18 ] (Additional file 2).

The multi-target interventions consisted of five successful interventions [ 44 , 45 , 46 , 47 , 48 ] and one unsuccessful intervention [ 49 ]. Sibling studies were only identified from one study [ 48 ]. The interventions were delivered in five countries across: South America (1 from Brazil [ 46 ]), Asia–Pacific (4 from China [ 44 , 45 , 47 , 49 ]), Europe (1 from Italy [ 48 ], 1 from Ireland [ 48 ], and 1 from Germany [ 48 ]). Three studies were conducted in high-income countries and five studies in upper middle-income countries. The multi-target interventions targeted women, health providers and health organisations. For this analysis, however, we only consider the components of the intervention that targeted women, which was typically childbirth education. One study came from Chen et al. (2018) [ 18 ] and was graded as having some concerns [ 47 ], two studies from Opiyo et al. (2020) [ 23 ] were graded as having no serious concerns [ 45 , 46 ], and three studies are newly published studies assessed as low [ 44 ] and some concerns about risk of bias [ 48 , 49 ] Table 2 and 3 show characteristics of included studies.

The childbirth education interventions included information about mode of birth, birth process, mental health and coping strategies, pain relief methods, and partners’ roles in birth. Most interventions were delivered in group settings, and only in three studies they were delivered on a one-to-one basis [ 38 , 41 , 42 ]. Only one study explicitly stated that the intervention was individualised to a woman’s unique needs and experiences [ 38 ].

Overall, there was limited theory used to design interventions among the included studies: less than half of interventions (7/17) explicitly used theory in designing the intervention. Among the seven interventions that used theory in intervention development, the theories included the health promotion-disease prevention framework [ 38 ], midwifery counselling framework [ 41 ], cognitive behavioural therapy [ 42 ], Ost’s applied relaxation [ 70 ], conceptual model of parenting [ 71 ], attachment and social cognitive theories [ 37 ], and healthcare improvement scale-up framework [ 46 ]. The remaining 10 studies only relied on previously published studies to design the interventions. We identified very limited process evaluation or implementation outcome evidence related to the included interventions, which is a limitation of the field of CS and clinical interventions more broadly.

• Qualitative comparative analysis

Model 1 – How birth information was provided to women

Model 1 is constructed based on the finding from Kingdon et al. (2018) [ 22 ] that women and communities enjoy learning new birth information, as it opens up new ways of thinking about vaginal birth and CS. Learning new information allows them to understand better the benefits and risks of CS and vaginal births, as well as increase their knowledge about CS [ 22 ].

We used four conditions in constructing model 1 truth table: 1) the provision of information, education, and communication (IEC) materials on what to expect during labour and birth, 2) type of education delivered (antenatal education or psychoeducation), and 3) group-based intervention delivery. We explored this model considering other conditions, such as type of information provided (e.g. information about mode of birth including birth process, mental health and coping strategies, pain relief), delivery technique (e.g. didactic, practical) and frequency and duration of intervention delivery; however these additional conditions did not result in configurations.

Of 16 possible configurations, we identified seven configurations (Table 4 ). The first two row shows perfect consistency of configurations (inclusion = 1) in five studies [ 37 , 68 , 69 , 70 , 71 ] in which all conditions are present, except antenatal education or psychoeducation. The remaining configurations are unsuccessful interventions. Interestingly, when either IEC materials or group-based intervention delivery are present (but not both), implementation is likely to be unsuccessful (rows 3–7).

Boolean minimisation identified two intermediate pathways to successful interventions (Fig.  2 ). The two pathways are similar, except for one condition: type of education. The antenatal education or psychoeducation materials is the content tailored to the type of women they target. Therefore, from the two pathways, we can see that the presence of distribution of IEC materials on birth information and group-based intervention delivery of either antenatal education to the general population of women (e.g. not groups of women with specific risks or conditions) or psychoeducation to women with fear of birth trigger successful interventions. From this solution, we can see that the successful interventions are consistently characterised by the presence of both IEC materials and group-based intervention delivery.

Intermediate pathways from model 1 that trigger successful interventions targeting pregnant women to optimise CS. In QCA, asterisk (*) denotes an ‘AND’ relationship; Inclusion score (InclS), also known as consistency, indicates the degree to which the evidence is consistent with the hypothesis that there is sufficient relation between the configuration and the outcome; Proportional Reduction in Inconsistency (PRI) refers to the extent in which a configuration is sufficient in triggering successful outcome as well as the negation of the outcome; Coverage score (CovS) refers to percentage of cases in which the configuration is valid

Model 2 – Emotional support was provided to women

Model 2 was constructed based on the theory that women desire emotional support alongside the communication of information about childbirth [ 22 ]. This includes emotional support from husbands or partners, health professional, or doulas [ 22 ]. Furthermore, Kingdon et al. (2018) describe the importance of two-way conversation and dialogue between women and providers during pregnancy care, particularly to ensure the opportunity for discussion [ 22 ]. Interventions may generate more questions than they answered, creating the need and desire of women to have more dialogue with health professionals [ 22 ]. Women considered intervention content to be most useful when it complements clinical care, is consistent with advice from health professionals and provides a basis for more informed, meaningful dialogue between women and care providers [ 22 ].

Based on this underlying theory, we constructed model 3 truth table by considering three conditions representative of providing emotional support to women, including partner or family member involvement, group-based intervention delivery which provide social or peer support to women, and opportunity for women to interact with health providers. Of 8 possible configurations, we identified six configurations (Table 5 ). The first three rows represent successful interventions with perfect consistency (inclusion = 1). The first row shows successful interventions with all conditions present. The second and third row shows successful interventions with all conditions except partner or family member involvement or interaction with health providers. The remaining rows represent unsuccessful interventions, where at least two conditions are absent.

Boolean minimisation identified two intermediate pathways to successful interventions (Fig.  3 ). In the first pathway, the partner or family members involvement and group-based intervention delivery enable successful interventions. In the second pathway, however, when partner or family members are not involved, successful interventions can happen only when interaction with health providers is included alongside group-based intervention. From these two pathways, we can see that group-based intervention, involvement of partner and family member, and opportunity for women to interact with providers seem to be important in driving intervention success.

Intermediate pathways from model 2 that trigger successful interventions targeting pregnant women to optimise CS. In QCA, asterisk (*) denotes an ‘AND’ relationship; Inclusion score (InclS), also known as consistency, indicates the degree to which the evidence is consistent with the hypothesis that there is sufficient relation between the configuration and the outcome; Proportional Reduction in Inconsistency (PRI) refers to the extent in which a configuration is sufficient in triggering successful outcome as well as the negation of the outcome; Coverage score (CovS) refers to percentage of cases in which the configuration is valid

Consolidated model – Essential conditions to prompt successful interventions focusing on women

Using the identified important conditions observed in models 1 and 2, we constructed a consolidated model to examine the final essential conditions which could prompt successful educational interventions targeting women. We merged and tested four conditions: the provision of IEC materials on what to expect during labour and birth, group-based intervention delivery, partner or family member involvement, and opportunity for interaction between women and health providers.

Of the 16 possible configurations, we identified six configurations (Table 6 ). The first three rows show configurations resulting in successful interventions with perfect consistency (inclusion = 1). The first row shows successful interventions with all conditions present; the second and third rows show successful interventions with all conditions present except interaction with health providers or partner or family member involvement. The remaining three rows are configurations of unsuccessful interventions, missing at least two conditions, including the consistent absence of partner or family member involvement.

Boolean minimisation identified two intermediate pathways to successful intervention (Fig.  4 ). The first pathway shows that the opportunity for women to interact with health providers, provision of IEC materials, and group-based intervention delivery prompts successful interventions. The second pathway, however, shows that when there is no opportunity for women to interact with health providers, it is important to have partner or family member involvement alongside group-based intervention delivery and provision of IEC materials. These two pathways suggest that the delivery of educational interventions accompanied by provision of IEC materials and presence of emotional support for women during the intervention is important to trigger successful interventions. These pathways also emphasise that emotional support for women during the intervention can come from either partner, family member, or health provider. For the consolidated model, we did not simplify the solution further, as the intermediate solution is more theoretically sound compared to the most parsimonious solution.

Intermediate pathways from consolidated model that trigger successful interventions targeting pregnant women to optimise CS.  In QCA, asterisk (*) denotes an ‘AND’ relationship; Inclusion score (InclS), also known as consistency, indicates the degree to which the evidence is consistent with the hypothesis that there is sufficient relation between the configuration and the outcome; Proportional Reduction in Inconsistency (PRI) refers to the extent in which a configuration is sufficient in triggering successful outcome as well as the negation of the outcome; Coverage score (CovS) refers to percentage of cases in which the configuration is valid.

Sub-analysis – Interventions targeting both women and health providers or systems

In this sub-analysis, we run the important conditions identified from the consolidated model, added condition of multi-target intervention, and applied it to 17 interventions: 11 interventions targeting women, and six interventions targeting both women and health providers or systems (multi-target interventions).

Of 32 possible configurations, we identified eight configurations (Table 7 ). The first four rows show configurations with successful interventions with perfect consistency (inclusion = 1). The first row is where all the multi-target interventions are clustered, except the unsuccessful intervention Zhang (2020) [ 49 ], and where all the conditions are present. All the conditions in the second to fourth rows are present, except multi-target interventions (all rows), interaction with health providers (third row) and partner and family member involvement (fourth row). The remaining rows are all configurations to unsuccessful interventions, where at least three conditions are missing, except row 8, which is a single case row. This case is the only multi-target intervention that is unsuccessful and in which partner or family members were not involved.

The Boolean minimisation identified two intermediate pathways (Fig.  5 ). The first pathway shows that partner or family involvement, provision of IEC materials, and group-based intervention delivery prompt successful interventions. The first pathway is comprised of all five successful multi-target interventions [ 44 , 45 , 46 , 47 , 48 ] and four of 11 interventions targeting only women [ 37 , 68 , 69 , 71 ]. The second pathway shows that when multi-target interventions are absent, but when interaction with health providers is present, alongside provision of IEC materials and group-based intervention delivery, it prompts successful interventions (3/11 interventions targeting women only [ 37 , 69 , 70 ]). The first pathway shows that there are successful configurations with and without multi-target interventions. Therefore, similar to the interventions targeting women, when implementing multi-target interventions, intervention components targeting women are more likely to be successful when partners or family members are involved, interventions are implemented through group-based intervention delivery, IEC materials were provided, and there is an opportunity for women to interact with health providers.

Intermediate pathways from multi-target interventions sub-analysis that trigger successful interventions targeting pregnant women to optimise CS. In QCA, asterisk (*) denotes an ‘AND’ relationship; Inclusion score (InclS), also known as consistency, indicates the degree to which the evidence is consistent with the hypothesis that there is sufficient relation between the configuration and the outcome; Proportional Reduction in Inconsistency (PRI) refers to the extent in which a configuration is sufficient in triggering successful outcome as well as the negation of the outcome; Coverage score (CovS) refers to percentage of cases in which the configuration is valid

To summarise, there are four essential intervention components which trigger successful educational interventions focusing on pregnant women to reduce CS, this includes 1) group-based intervention delivery, 2) provision of IEC materials on what to expect during labour and birth, 3) partner or family member involvement on the intervention, and 4) opportunity for women to interact with health providers. These conditions do not work in siloed or independently but instead work jointly as parts of configurations to enable successful interventions.

Our extensive QCA identified configurations of essential intervention components which are sufficient to trigger successful interventions to optimised CS. Educational interventions focusing on women were successful by: 1) leveraging social or peer support through group-based intervention delivery, 2) improving women’s knowledge and awareness of what to expect during labour and birth, 3) ensuring women have emotional support through partner or family participation in the intervention, and 4) providing opportunities for women to interact with health providers. We found that the absence of two or more of the above characteristics in an intervention result in unsuccessful interventions. Unlike our logic model, which predicted engagement strategies (i.e. intensity, frequency, technique, recruitment, incentives) to be essential to intervention success, we found that “support” seems to be central in maximising benefits of interventions targeting women.

Group-based intervention delivery is present across all four truth tables and eight pathways leading to successful intervention implementation, suggesting that group-based intervention delivery is an essential component of interventions targeting women. Despite this, we cannot conclude that group-based intervention delivery is a necessary condition, as there may be other pathways not captured in this QCA. The importance of group-based intervention delivery may be due to the group setting providing women with a sense of confidence through peer support and engagement. In group-based interventions, women may feel more confident when learning with others and peer support may motivate women. Furthermore, all group-based interventions in our included studies are conducted at health facilities, which may provide women with more confidence that information is aligned with clinical recommendations. Evidence on benefits of group-based interventions involving women who are pregnant has been demonstrated previously [ 72 , 73 ]. Women reported that group-based interventions reduce their feelings of isolation, provide access to group support, and allow opportunities for them to share their experiences [ 72 , 74 , 75 , 76 ]. This is aligned with social support theory, in which social support through a group or social environment may provide women with feelings of reassurance, compassion, reduce feelings of uncertainty, increase sense of control, access to new contacts to solve problems, and provision of instrumental support, which eventually influence positive health behaviours [ 72 , 77 ]. Women may resolve their uncertainties around mode of birth by sharing their concerns with others and learning at the same time how others cope with it. These findings are consistent with the benefits associated with group-based antenatal care, which is recommended by WHO [ 78 , 79 ].

Kingdon et al. (2018) reported that women and communities liked learning new birth information, as it opens new ways of thinking about vaginal birth and CS, and educates about benefits of different modes of birth, including risks of CS. Our QCA is aligned with this finding where provision of information about birth through education delivery leads to successful interventions but with certain caveats. That is, provision of birth information should be accompanied by IEC materials and through group-based intervention delivery. There is not enough information to distinguish what type of IEC materials lead to successful intervention; however, it is important to note that the format of the IEC materials (such as paper-based or mobile application) may affect success. More work is needed to understand how women and families react to format of IEC materials; for example, will paper-based IEC materials be relegated over more modern methods of reaching women with information through digital applications? The QUALI-DEC (Quality decision-making (QUALI-DEC) by women and healthcare providers for appropriate use of caesarean section) study is currently implementing a decision-analysis tool to help women make an informed decision on preferred mode of birth using both a paper-based and mobile application that may shed some light on this [ 80 ].

Previous research has shown that women who participated in interventions aiming to reduce CS desired emotional support (from partners, doulas or health providers) alongside the communication about childbirth [ 22 ]. Our QCA is aligned with this finding in which emotional support from partners or family members is highly influential in leading to successful interventions. Partner involvement in maternity care has been extensively studied and has been demonstrated to improve maternal health care utilisation and outcomes [ 81 ]. Both women and their partners perceived that partner involvement is crucial as it facilitates men to learn directly from providers, thus promoting shared decision-making among women and partners and enabling partners to reinforce adherence to any beneficial suggestions [ 82 , 83 , 84 , 85 , 86 ]. Partners provide psychosocial support to women, for example through being present during pregnancy and the childbirth process, as well as instrumental support, which includes supporting women financially [ 82 , 83 , 84 ]. Despite the benefits of partner involvement, partner's participation in maternity care is still low [ 82 ], as reflected in this study where only four out of 11 included interventions on this study involved partner or family member involvement. Reasons for this low participation, which include unequal gender norms and limited health system capability [ 82 , 84 , 85 , 86 ], should be explored and addressed to ensure the benefits of the interventions.

Furthermore, our QCA demonstrates the importance of interaction with health providers to trigger successful interventions. The interaction of women with providers in CS decision-making, however, is on a “nexus of power, trust, and risk”, where it may be beneficial but can also reinforce the structural oppression of women [ 13 ]. A recent study on patient-provider interaction in CS decision-making concluded that the interaction between providers who are risk-averse, and women who are cautious about their pregnancies in the health system results in discouragement of vaginal births [ 87 ]. However, this decision could be averted by meaningful communication between women and providers where CS risks and benefits are communicated in an environment where vaginal birth is encouraged [ 87 ]. Furthermore, the reasons women desire interaction with providers can come from opposite directions. Some women see providers as the most trusted and knowledgeable source, in which women can trust the judgement and ensure that the information learned is reliable and evidenced-based [ 22 ]. On the other hand, some women may have scepticism towards providers where women understand that providers’ preference may negatively influence their preferred mode of birth [ 22 ]. Therefore, adequate, two-way interaction is important for women to build a good rapport with providers.

It is also important to note that we have limited evidence (3/17 intervention studies) involving women with previous CS. Vaginal birth after previous CS (VBAC) can be a safe and positive experience for some women, but there are also potential risks depending on their obstetric history [ 88 , 89 , 90 ]. Davis (2020) found that women were motivated to have VBAC due to negative experiences of CS, such as the difficult recovery, and that health providers' roles served as pivotal drivers in motivating women towards VBAC [ 91 ]. Other than this, VBAC also requires giving birth in a suitably staffed and equipped maternity unit, with staff trained on VBAC, equipment for labour monitoring, and resources for emergency CS if needed [ 89 , 90 ]. There is comparatively less research conducted on VBAC and trial of labour after CS [ 88 ]. Therefore, more work is needed to explore if there are potentially different pathways that lead to successful intervention implementation for women with previous CS. It may be more likely that interventions targeting various stakeholders are more crucial in this group of women. For example, both education for women and partners or families, as well as training to upskill health providers might be needed to support VBAC.

Strength and limitations

We found many included studies had poor reporting of the interventions, including the general intervention components (e.g. presence of policies that may support interventions) and process evaluation components, which is reflective of the historical approach to reporting trial data. This poor reporting means we could not engage further in the interventions and thus may have missed important conditions that were not reported. However, we have attempted to compensate for limited process evaluation components by identifying all relevant sibling studies that could contribute to a better understanding of context. Furthermore, there are no studies conducted in low-income countries, despite rapidly increasing CS rates in these settings. Lastly, we were not able to conduct more nuanced analyses about CS, such as exploring how CS interventions impacted changes to emergency versus elective CS, VBAC, or instrumental birth, due to an insufficient number of studies and heterogeneity in outcome measurements. Therefore, it is important to note that we are not necessarily measuring the optimal outcome of interest—reducing unnecessary CS. However, it is unlikely that these non-clinical interventions will interfere with a decision of CS based on clinical indications.

Despite these limitations, this is the first study aiming to understand how certain interventions can be successful in targeting women to optimise CS use. We used the QCA approach and new analytical frameworks to re-analyse existing systematic review evidence to generate new knowledge. We ensure robustness through the use of a logic model and worked backwards in understanding what aspects are different in the intervention across different outcomes. The use of QCA and qualitative evidence synthesis ensured that the results are theory-driven, incorporate participants’ perspectives into the analysis, and explored iteratively to find the appropriate configurations, reducing the risk of data fishing. Lastly, this QCA extends the understanding of effectiveness review conducted by Chen et al. (2018) [ 18 ] by explaining the potential intervention components which may influence heterogeneity.

Implications for practice and research

To aid researchers and health providers to reduce CS in their contexts and designing educational interventions targeting women during pregnancy, we have developed a checklist of key components or questions to consider when designing the interventions that may help lead to successful implementation:

Is the intervention delivered in a group setting?

Are IEC materials on what to expect during labour and birth disseminated to women?

Are women’s partners or families involved in the intervention?

Do women have opportunities to interact with health providers?

We have used this checklist to explore the extent to which the included interventions in our QCA include these components using a matrix model (Fig.  6 ).

Matrix model assessing the extent to which the included intervention studies have essential intervention components identified in the QCA

Additionally, future research on interventions to optimise the use of CS should report the intervention components implemented, including process outcomes such as fidelity, attrition, contextual factors (e.g. policies, details of how the intervention is delivered), and stakeholder factors (e.g. women’s perceptions and satisfaction). These factors are important in not just evaluating whether the intervention is successful or not, but also in exploring why similar interventions can work in one but not in another context. There is also a need for more intervention studies implementing VBAC to reduce CS, to understand how involving women with previous CS may result in successful interventions. Furthermore, more studies understanding impact of the interventions targeting women in LMICs are needed.

This QCA illustrates crucial intervention components and potential pathways that can trigger successful educational interventions to optimise CS, focusing on pregnant women. The following intervention components are found to be sufficient in triggering successful outcomes: 1) group-based delivery, 2) provision of IEC materials, 3) partner or family member involvement, and 4) opportunity for women to interact with health providers. These intervention components do not work in siloed or independently but instead work jointly as parts of configurations to enable successful interventions. Researchers, trialists, hospitals, or other institutions and stakeholders planning interventions focusing on pregnant women can consider including these components to ensure benefits. More studies understanding impact of the interventions targeting women to optimise CS are needed from LMICs. Researchers should clearly describe and report intervention components in trials, and consider how process evaluations can help explain why trials were successful or not. More robust trial reporting and process evaluations can help to better understand mechanisms of action and why interventions may work in one context yet not another.

Availability of data and materials

Additional information files have been provided and more data may be provided upon request to [email protected].

Abbreviations

Coverage score

• Caesarean section

Crisp set qualitative comparative analysis

Fuzzy set qualitative comparative analysis

Information, education, and communication

Inclusion score

Low- and middle-income countries

Proportional reduction in inconsistency

Quality decision-making by women and healthcare providers for appropriate use of caesarean section

Vaginal birth after previous caesarean section

World Health Organization

World Health Organization. WHO statement on caesarean section rates. Available from: https://www.who.int/publications/i/item/WHO-RHR-15.02 . Cited 20 Sept 2023.

Zahroh RI, Disney G, Betrán AP, Bohren MA. Trends and sociodemographic inequalities in the use of caesarean section in Indonesia, 1987–2017. BMJ Global Health. 2020;5:e003844. https://doi.org/10.1136/bmjgh-2020-003844 .

Article   PubMed   PubMed Central   Google Scholar  

Betran AP, Ye J, Moller A-B, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health. 2021;6:e005671. https://doi.org/10.1136/bmjgh-2021-005671 .

Boerma T, Ronsmans C, Melesse DY, Barros AJD, Barros FC, Juan L, et al. Global epidemiology of use of and disparities in caesarean sections. The Lancet. 2018;392:1341–8. https://doi.org/10.1016/S0140-6736(18)31928-7 .

Article   Google Scholar  

Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, et al. Short-term and long-term effects of caesarean section on the health of women and children. Lancet. 2018;392:1349–57. https://doi.org/10.1016/S0140-6736(18)31930-5 .

Article   PubMed   Google Scholar  

Abenhaim HA, Tulandi T, Wilchesky M, Platt R, Spence AR, Czuzoj-Shulman N, et al. Effect of Cesarean Delivery on Long-term Risk of Small Bowel Obstruction. Obstet Gynecol. 2018;131:354–9. https://doi.org/10.1097/AOG.0000000000002440 .

Gurol-Urganci I, Bou-Antoun S, Lim CP, Cromwell DA, Mahmood TA, Templeton A, et al. Impact of Caesarean section on subsequent fertility: a systematic review and meta-analysis. Hum Reprod. 2013;28:1943–52. https://doi.org/10.1093/humrep/det130 .

Article   CAS   PubMed   Google Scholar  

Hesselman S, Högberg U, Råssjö E-B, Schytt E, Löfgren M, Jonsson M. Abdominal adhesions in gynaecologic surgery after caesarean section: a longitudinal population-based register study. BJOG: An Int J Obstetrics Gynaecology. 2018;125:597–603. https://doi.org/10.1111/1471-0528.14708 .

Article   CAS   Google Scholar  

Tita ATN, Landon MB, Spong CY, Lai Y, Leveno KJ, Varner MW, et al. Timing of elective repeat cesarean delivery at term and neonatal outcomes. N Engl J Med. 2009;360:111–20. https://doi.org/10.1056/NEJMoa0803267 .

Article   CAS   PubMed   PubMed Central   Google Scholar  

Wilmink FA, Hukkelhoven CWPM, Lunshof S, Mol BWJ, van der Post JAM, Papatsonis DNM. Neonatal outcome following elective cesarean section beyond 37 weeks of gestation: a 7-year retrospective analysis of a national registry. Am J Obstet Gynecol. 2010;202(250):e1-8. https://doi.org/10.1016/j.ajog.2010.01.052 .

Keag OE, Norman JE, Stock SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLoS Med. 2018;15:e1002494. https://doi.org/10.1371/journal.pmed.1002494 .

Ye J, Betrán AP, Guerrero Vela M, Souza JP, Zhang J. Searching for the optimal rate of medically necessary cesarean delivery. Birth. 2014;41:237–44. https://doi.org/10.1111/birt.12104 .

Eide KT, Morken N-H, Bærøe K. Maternal reasons for requesting planned cesarean section in Norway: a qualitative study. BMC Pregnancy Childbirth. 2019;19:102. https://doi.org/10.1186/s12884-019-2250-6 .

Long Q, Kingdon C, Yang F, Renecle MD, Jahanfar S, Bohren MA, et al. Prevalence of and reasons for women’s, family members’, and health professionals’ preferences for cesarean section in China: A mixed-methods systematic review. PLoS Med. 2018;15. https://doi.org/10.1371/journal.pmed.1002672 .

McAra-Couper J, Jones M, Smythe L. Caesarean-section, my body, my choice: The construction of ‘informed choice’ in relation to intervention in childbirth. Fem Psychol. 2012;22:81–97. https://doi.org/10.1177/0959353511424369 .

Panda S, Begley C, Daly D. Clinicians’ views of factors influencing decision-making for caesarean section: A systematic review and metasynthesis of qualitative, quantitative and mixed methods studies. PLoS One 2018;13. https://doi.org/10.1371/journal.pone.0200941 .

Takegata M, Smith C, Nguyen HAT, Thi HH, Thi Minh TN, Day LT, et al. Reasons for increased Caesarean section rate in Vietnam: a qualitative study among Vietnamese mothers and health care professionals. Healthcare. 2020;8:41. https://doi.org/10.3390/healthcare8010041 .

Chen I, Opiyo N, Tavender E, Mortazhejri S, Rader T, Petkovic J, et al. Non-clinical interventions for reducing unnecessary caesarean section. Cochrane Database Syst Rev. 2018. https://doi.org/10.1002/14651858.CD005528.pub3 .

Catling-Paull C, Johnston R, Ryan C, Foureur MJ, Homer CSE. Non-clinical interventions that increase the uptake and success of vaginal birth after caesarean section: a systematic review. J Adv Nurs. 2011;67:1662–76. https://doi.org/10.1111/j.1365-2648.2011.05662.x .

Kingdon C, Downe S, Betran AP. Non-clinical interventions to reduce unnecessary caesarean section targeted at organisations, facilities and systems: Systematic review of qualitative studies. PLOS ONE. 2018;13:e0203274. https://doi.org/10.1371/journal.pone.0203274 .

Kingdon C, Downe S, Betran AP. Interventions targeted at health professionals to reduce unnecessary caesarean sections: a qualitative evidence synthesis. BMJ Open. 2018;8:e025073. https://doi.org/10.1136/bmjopen-2018-025073 .

Kingdon C, Downe S, Betran AP. Women’s and communities’ views of targeted educational interventions to reduce unnecessary caesarean section: a qualitative evidence synthesis. Reprod Health. 2018;15:130. https://doi.org/10.1186/s12978-018-0570-z .

Opiyo N, Young C, Requejo JH, Erdman J, Bales S, Betrán AP. Reducing unnecessary caesarean sections: scoping review of financial and regulatory interventions. Reprod Health. 2020;17:133. https://doi.org/10.1186/s12978-020-00983-y .

Harris K, Kneale D, Lasserson TJ, McDonald VM, Grigg J, Thomas J. School-based self-management interventions for asthma in children and adolescents: a mixed methods systematic review. Cochrane Database Syst Rev. 2019. https://doi.org/10.1002/14651858.CD011651.pub2 .

World Health Organization. Robson Classifcation: Implementation Manual. 2017. Available from: https://www.who.int/publications/i/item/9789241513197 . Cited 20 Sept 2023.

Zahroh RI, Kneale D, Sutcliffe K, Vazquez Corona M, Opiyo N, Homer CSE, et al. Interventions targeting healthcare providers to optimise use of caesarean section: a qualitative comparative analysis to identify important intervention features. BMC Health Serv Res. 2022;22:1526. https://doi.org/10.1186/s12913-022-08783-9 .

World Health Organization. WHO recommendations: non-clinical interventions to reduce unnecessary caesarean sections. 2018. Available from: https://www.who.int/publications/i/item/9789241550338 . Cited 20 Sept 2023.

Hanckel B, Petticrew M, Thomas J, Green J. The use of Qualitative Comparative Analysis (QCA) to address causality in complex systems: a systematic review of research on public health interventions. BMC Public Health. 2021;21:877. https://doi.org/10.1186/s12889-021-10926-2 .

Melendez-Torres GJ, Sutcliffe K, Burchett HED, Rees R, Richardson M, Thomas J. Weight management programmes: Re-analysis of a systematic review to identify pathways to effectiveness. Health Expect. 2018;21:574–84. https://doi.org/10.1111/hex.12667 .

Chatterley C, Javernick-Will A, Linden KG, Alam K, Bottinelli L, Venkatesh M. A qualitative comparative analysis of well-managed school sanitation in Bangladesh. BMC Public Health. 2014;14:6. https://doi.org/10.1186/1471-2458-14-6 .

Thomas J, O’Mara-Eves A, Brunton G. Using qualitative comparative analysis (QCA) in systematic reviews of complex interventions: a worked example. Syst Rev. 2014;3:67. https://doi.org/10.1186/2046-4053-3-67 .

Dușa A. QCA with R: A Comprehensive Resource. 2021. Available from: https://bookdown.org/dusadrian/QCAbook/ . Cited 20 Sept 2023.

Kneale D, Sutcliffe K, Thomas J. Critical Appraisal of Reviews Using Qualitative Comparative Analyses (CARU-QCA): a tool to critically appraise systematic reviews that use qualitative comparative analysis. In: Abstracts of the 26th Cochrane Colloquium, Santiago, Chile. Cochrane Database of Systematic Reviews 2020;(1 Suppl 1). https://doi.org/10.1002/14651858.CD201901 .

Sutcliffe K, Thomas J, Stokes G, Hinds K, Bangpan M. Intervention Component Analysis (ICA): a pragmatic approach for identifying the critical features of complex interventions. Syst Rev. 2015;4:140. https://doi.org/10.1186/s13643-015-0126-z .

Melendez-Torres GJ, Sutcliffe K, Burchett HED, Rees R, Thomas J. Developing and testing intervention theory by incorporating a views synthesis into a qualitative comparative analysis of intervention effectiveness. Res Synth Methods. 2019;10:389–97. https://doi.org/10.1002/jrsm.1341 .

Thomas J, Harden A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol. 2008;8:45. https://doi.org/10.1186/1471-2288-8-45 .

Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Saisto T. Obstetric outcome after intervention for severe fear of childbirth in nulliparous women – randomised trial. BJOG: An Int J Obstetrics Gynaecology. 2013;120:75–84. https://doi.org/10.1111/1471-0528.12011 .

Fraser W, Maunsell E, Hodnett E, Moutquin JM. Randomized controlled trial of a prenatal vaginal birth after cesarean section education and support program Childbirth alternatives Post-Cesarean study group. Am J Obstet Gynecol. 1997;176:419–25. https://doi.org/10.1016/s0002-9378(97)70509-x .

Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeili-Vardanjani A, Rafiei H. Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in Hamadan, Iran: a randomized controlled trial. J Family Reprod Health. 2016;10:115–21.

PubMed   PubMed Central   Google Scholar  

Navaee M, Abedian Z. Effect of role play education on primiparous women’s fear of natural delivery and their decision on the mode of delivery. Iran J Nurs Midwifery Res. 2015;20:40–6.

Fenwick J, Toohill J, Gamble J, Creedy DK, Buist A, Turkstra E, et al. Effects of a midwife psycho-education intervention to reduce childbirth fear on women’s birth outcomes and postpartum psychological wellbeing. BMC Pregnancy Childbirth. 2015;15:284. https://doi.org/10.1186/s12884-015-0721-y .

Saisto T, Salmela-Aro K, Nurmi J-E, Könönen T, Halmesmäki E. A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol. 2001;98:820–6. https://doi.org/10.1016/S0029-7844(01)01552-6 .

Montgomery AA, Emmett CL, Fahey T, Jones C, Ricketts I, Patel RR, et al. Two decision aids for mode of delivery among women with previous Caesarean section: randomised controlled trial. BMJ: British Medic J. 2007;334:1305–9.

Xia X, Zhou Z, Shen S, Lu J, Zhang L, Huang P, et al. Effect of a two-stage intervention package on the cesarean section rate in Guangzhou, China: A before-and-after study. PLOS Medicine. 2019;16:e1002846. https://doi.org/10.1371/journal.pmed.1002846 .

Yu Y, Zhang X, Sun C, Zhou H, Zhang Q, Chen C. Reducing the rate of cesarean delivery on maternal request through institutional and policy interventions in Wenzhou. China PLoS ONE. 2017;12:1–12. https://doi.org/10.1371/journal.pone.0186304 .

Borem P, de Cássia SR, Torres J, Delgado P, Petenate AJ, Peres D, et al. A quality improvement initiative to increase the frequency of Vaginal delivery in Brazilian hospitals. Obstet Gynecol. 2020;135:415–25. https://doi.org/10.1097/AOG.0000000000003619 .

Ma R, Lao Terence T, Sun Y, Xiao H, Tian Y, Li B, et al. Practice audits to reduce caesareans in a tertiary referral hospital in south-western China. Bulletin World Health Organiz. 2012;90:488–94. https://doi.org/10.2471/BLT.11.093369 .

Clarke M, Devane D, Gross MM, Morano S, Lundgren I, Sinclair M, et al. OptiBIRTH: a cluster randomised trial of a complex intervention to increase vaginal birth after caesarean section. BMC Pregnancy Childbirth. 2020;20:143. https://doi.org/10.1186/s12884-020-2829-y .

Zhang L, Zhang L, Li M, Xi J, Zhang X, Meng Z, et al. A cluster-randomized field trial to reduce cesarean section rates with a multifaceted intervention in Shanghai. China BMC Medicine. 2020;18:27. https://doi.org/10.1186/s12916-020-1491-6 .

Fenwick J, Gamble J, Creedy DK, Buist A, Turkstra E, Sneddon A, et al. Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention. BMC Pregnancy Childbirth. 2013;13:190. https://doi.org/10.1186/1471-2393-13-190 .

Toohill J, Fenwick J, Gamble J, Creedy DK, Buist A, Turkstra E, et al. A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women. Birth. 2014;41:384–94. https://doi.org/10.1111/birt.12136 .

Toohill J, Callander E, Gamble J, Creedy D, Fenwick J. A cost effectiveness analysis of midwife psycho-education for fearful pregnant women – a health system perspective for the antenatal period. BMC Pregnancy Childbirth. 2017;17:217. https://doi.org/10.1186/s12884-017-1404-7 .

Turkstra E, Mihala G, Scuffham PA, Creedy DK, Gamble J, Toohill J, et al. An economic evaluation alongside a randomised controlled trial on psycho-education counselling intervention offered by midwives to address women’s fear of childbirth in Australia. Sex Reprod Healthc. 2017;11:1–6. https://doi.org/10.1016/j.srhc.2016.08.003 .

Emmett CL, Shaw ARG, Montgomery AA, Murphy DJ, DiAMOND study group. Women’s experience of decision making about mode of delivery after a previous caesarean section: the role of health professionals and information about health risks. BJOG 2006;113:1438–45. https://doi.org/10.1111/j.1471-0528.2006.01112.x .

Emmett CL, Murphy DJ, Patel RR, Fahey T, Jones C, Ricketts IW, et al. Decision-making about mode of delivery after previous caesarean section: development and piloting of two computer-based decision aids. Health Expect. 2007;10:161–72. https://doi.org/10.1111/j.1369-7625.2006.00429.x .

Hollinghurst S, Emmett C, Peters TJ, Watson H, Fahey T, Murphy DJ, et al. Economic evaluation of the DiAMOND randomized trial: cost and outcomes of 2 decision aids for mode of delivery among women with a previous cesarean section. Med Decis Making. 2010;30:453–63. https://doi.org/10.1177/0272989X09353195 .

Frost J, Shaw A, Montgomery A, Murphy D. Women’s views on the use of decision aids for decision making about the method of delivery following a previous caesarean section: Qualitative interview study. BJOG : An Int J Obstetrics Gynaecology. 2009;116:896–905. https://doi.org/10.1111/j.1471-0528.2009.02120.x .

Rees KM, Shaw ARG, Bennert K, Emmett CL, Montgomery AA. Healthcare professionals’ views on two computer-based decision aids for women choosing mode of delivery after previous caesarean section: a qualitative study. BJOG. 2009;116:906–14. https://doi.org/10.1111/j.1471-0528.2009.02121.x .

Emmett CL, Montgomery AA, Murphy DJ. Preferences for mode of delivery after previous caesarean section: what do women want, what do they get and how do they value outcomes? Health Expect. 2011;14:397–404. https://doi.org/10.1111/j.1369-7625.2010.00635.x .

Bastani F, Hidarnia A, Montgomery KS, Aguilar-Vafaei ME, Kazemnejad A. Does relaxation education in anxious primigravid Iranian women influence adverse pregnancy outcomes?: a randomized controlled trial. J Perinat Neonatal Nurs. 2006;20:138–46. https://doi.org/10.1097/00005237-200604000-00007 .

Feinberg ME, Kan ML. Establishing Family Foundations: Intervention Effects on Coparenting, Parent/Infant Well-Being, and Parent-Child Relations. J Fam Psychol. 2008;22:253–63. https://doi.org/10.1037/0893-3200.22.2.253 .

Me F, Ml K, Mc G. Enhancing coparenting, parenting, and child self-regulation: effects of family foundations 1 year after birth. Prevention Science: Official J Soc Prevention Res. 2009;10. https://doi.org/10.1007/s11121-009-0130-4 .

Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Saisto T. Life satisfaction, general well-being and costs of treatment for severe fear of childbirth in nulliparous women by psychoeducative group or conventional care attendance. Acta Obstet Gynecol Scand. 2015;94:527–33. https://doi.org/10.1111/aogs.12594 .

Rouhe H, Salmela-Aro K, Toivanen R, Tokola M, Halmesmäki E, Ryding E-L, et al. Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience–a randomised controlled trial. J Psychosom Obstet Gynaecol. 2015;36:1–9. https://doi.org/10.3109/0167482X.2014.980722 .

Healy P, Smith V, Savage G, Clarke M, Devane D, Gross MM, et al. Process evaluation for OptiBIRTH, a randomised controlled trial of a complex intervention designed to increase rates of vaginal birth after caesarean section. Trials. 2018;19:9. https://doi.org/10.1186/s13063-017-2401-x .

Clarke M, Savage G, Smith V, Daly D, Devane D, Gross MM, et al. Improving the organisation of maternal health service delivery and optimising childbirth by increasing vaginal birth after caesarean section through enhanced women-centred care (OptiBIRTH trial): study protocol for a randomised controlled trial (ISRCTN10612254). Trials. 2015;16:542. https://doi.org/10.1186/s13063-015-1061-y .

Lundgren I, Healy P, Carroll M, Begley C, Matterne A, Gross MM, et al. Clinicians’ views of factors of importance for improving the rate of VBAC (vaginal birth after caesarean section): a study from countries with low VBAC rates. BMC Pregnancy Childbirth. 2016;16:350. https://doi.org/10.1186/s12884-016-1144-0 .

Sharifirad G, Rezaeian M, Soltani R, Javaheri S, Mazaheri MA. A survey on the effects of husbands’ education of pregnant women on knowledge, attitude, and reducing elective cesarean section. J Educ Health Promotion. 2013;2:50. https://doi.org/10.4103/2277-9531.119036 .

Valiani M, Haghighatdana Z, Ehsanpour S. Comparison of childbirth training workshop effects on knowledge, attitude, and delivery method between mothers and couples groups referring to Isfahan health centers in Iran. Iran J Nurs Midwifery Res. 2014;19:653–8.

Bastani F, Hidarnia A, Kazemnejad A, Vafaei M, Kashanian M. A randomized controlled trial of the effects of applied relaxation training on reducing anxiety and perceived stress in pregnant women. J Midwifery Womens Health. 2005;50:e36-40. https://doi.org/10.1016/j.jmwh.2004.11.008 .

Feinberg ME, Roettger ME, Jones DE, Paul IM, Kan ML. Effects of a psychosocial couple-based prevention program on adverse birth outcomes. Matern Child Health J. 2015;19:102–11. https://doi.org/10.1007/s10995-014-1500-5 .

Evans K, Spiby H, Morrell CJ. Developing a complex intervention to support pregnant women with mild to moderate anxiety: application of the medical research council framework. BMC Pregnancy Childbirth. 2020;20:777. https://doi.org/10.1186/s12884-020-03469-8 .

Rising SS. Centering pregnancy. An interdisciplinary model of empowerment. J Nurse Midwifery. 1998;43:46–54. https://doi.org/10.1016/s0091-2182(97)00117-1 .

Breustedt S, Puckering C. A qualitative evaluation of women’s experiences of the Mellow Bumps antenatal intervention. British J Midwife. 2013;21:187–94. https://doi.org/10.12968/bjom.2013.21.3.187 .

Evans K, Spiby H, Morrell JC. Non-pharmacological interventions to reduce the symptoms of mild to moderate anxiety in pregnant women a systematic review and narrative synthesis of women’s views on the acceptability of and satisfaction with interventions. Arch Womens Ment Health. 2020;23:11–28. https://doi.org/10.1007/s00737-018-0936-9 .

Hoddinott P, Chalmers M, Pill R. One-to-one or group-based peer support for breastfeeding? Women’s perceptions of a breastfeeding peer coaching intervention. Birth. 2006;33:139–46. https://doi.org/10.1111/j.0730-7659.2006.00092.x .

Heaney CA, Israel BA. Social networks and social support. In Glanz K, Rimer BK, Viswanath K (Eds.), Health behavior and health education: Theory, research, and practice. Jossey-Bass; 2008. pp. 189–210. https://psycnet.apa.org/record/2008-17146-009 .

World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. 2016. Available from: https://www.who.int/publications/i/item/9789241549912 . Cited 20 Sept 2023.

World Health Organization. WHO recommendation on group antenatal care. WHO - RHL. 2021. Available from: https://srhr.org/rhl/article/who-recommendation-on-group-antenatal-care . Cited 20 Sept 2023.

Dumont A, Betrán AP, Kabore C, de Loenzien M, Lumbiganon P, Bohren MA, et al. Implementation and evaluation of nonclinical interventions for appropriate use of cesarean section in low- and middle-income countries: protocol for a multisite hybrid effectiveness-implementation type III trial. Implementation Science 2020. https://doi.org/10.21203/rs.3.rs-35564/v2 .

Tokhi M, Comrie-Thomson L, Davis J, Portela A, Chersich M, Luchters S. Involving men to improve maternal and newborn health: A systematic review of the effectiveness of interventions. PLOS ONE. 2018;13:e0191620. https://doi.org/10.1371/journal.pone.0191620 .

Gibore NS, Bali TAL. Community perspectives: An exploration of potential barriers to men’s involvement in maternity care in a central Tanzanian community. PLOS ONE. 2020;15:e0232939. https://doi.org/10.1371/journal.pone.0232939 .

Galle A, Plaieser G, Steenstraeten TV, Griffin S, Osman NB, Roelens K, et al. Systematic review of the concept ‘male involvement in maternal health’ by natural language processing and descriptive analysis. BMJ Global Health. 2021;6:e004909. https://doi.org/10.1136/bmjgh-2020-004909 .

Ladur AN, van Teijlingen E, Hundley V. Male involvement in promotion of safe motherhood in low- and middle-income countries: a scoping review. Midwifery. 2021;103:103089. https://doi.org/10.1016/j.midw.2021.103089 .

Comrie-Thomson L, Tokhi M, Ampt F, Portela A, Chersich M, Khanna R, et al. Challenging gender inequity through male involvement in maternal and newborn health: critical assessment of an emerging evidence base. Cult Health Sex. 2015;17:177–89. https://doi.org/10.1080/13691058.2015.1053412 .

Article   PubMed Central   Google Scholar  

Comrie-Thomson L, Gopal P, Eddy K, Baguiya A, Gerlach N, Sauvé C, et al. How do women, men, and health providers perceive interventions to influence men’s engagement in maternal and newborn health? A qualitative evidence synthesis. Soc Scie Medic. 2021;291:114475. https://doi.org/10.1016/j.socscimed.2021.114475 .

Doraiswamy S, Billah SM, Karim F, Siraj MS, Buckingham A, Kingdon C. Physician–patient communication in decision-making about Caesarean sections in eight district hospitals in Bangladesh: a mixed-method study. Reprod Health. 2021;18:34. https://doi.org/10.1186/s12978-021-01098-8 .

Dodd JM, Crowther CA, Huertas E, Guise J-M, Horey D. Planned elective repeat caesarean section versus planned vaginal birth for women with a previous caesarean birth. Cochrane Database Syst Rev. 2013. https://doi.org/10.1002/14651858.CD004224.pub3 .

Royal College of Obstetricians and Gynaecologists. Birth After Previous Caesarean Birth:Green-top Guideline No. 45. 2015. Available from: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_45.pdf . Cited 20 Sept 2023.

Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Birth after previous caesarean section. 2019. Available from: https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical-Obstetrics/Birth-after-previous-Caesarean-Section-(C-Obs-38)Review-March-2019.pdf?ext=.pdf . Cited 20 Sept 2023.

Davis D, Homer CS, Clack D, Turkmani S, Foureur M. Choosing vaginal birth after caesarean section: Motivating factors. Midwifery. 2020;88:102766. https://doi.org/10.1016/j.midw.2020.102766 .

Download references

Acknowledgements

We extend our thanks to Jim Berryman (Brownless Medical Library, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne) for his help in refining the search strategy for sibling studies.

This research was made possible with the support of UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co-sponsored programme executed by the World Health Organization (WHO). RIZ is supported by Melbourne Research Scholarship and Human Rights Scholarship from The University of Melbourne. CSEH is supported by a National Health and Medical Research Council (NHMRC) Principal Research Fellowship. MAB’s time is supported by an Australian Research Council Discovery Early Career Researcher Award (DE200100264) and a Dame Kate Campbell Fellowship (University of Melbourne Faculty of Medicine, Dentistry, and Health Sciences). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The contents of this publication are the responsibility of the authors and do not reflect the views of the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization.

Author information

Authors and affiliations.

Gender and Women’s Health Unit, Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia

Rana Islamiah Zahroh, Martha Vazquez Corona & Meghan A. Bohren

EPPI Centre, UCL Social Research Institute, University College London, London, UK

Katy Sutcliffe & Dylan Kneale

Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland

Ana Pilar Betrán & Newton Opiyo

Maternal, Child, and Adolescent Health Programme, Burnet Institute, Melbourne, VIC, Australia

Caroline S. E. Homer

You can also search for this author in PubMed   Google Scholar

Contributions

- Conceptualisation and study design: MAB, APB, RIZ

- Funding acquisition: MAB, APB

- Data curation: RIZ, MAB, MVC

- Investigation, methodology and formal analysis: all authors

- Visualisation: RIZ, MAB

- Writing – original draft preparation: RIZ, MAB

- Writing – review and editing: all authors

Corresponding author

Correspondence to Rana Islamiah Zahroh .

Ethics declarations

Ethics approval and consent to participate.

This study utilised published and openly available data, and thus ethics approval is not required.

Consent for publication

No direct individual contact is involved in this study, therefore consent for publication is not needed.

Competing interests

The authors declare no competing interests.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Additional file 1..

Logic model in optimizing CS use.

Additional file 2.

Risk of bias assessments.

Additional file 3.

Coding framework and calibration rules.

Additional file 4.

Coding framework as applied to each intervention (data table).

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

Zahroh, R.I., Sutcliffe, K., Kneale, D. et al. Educational interventions targeting pregnant women to optimise the use of caesarean section: What are the essential elements? A qualitative comparative analysis. BMC Public Health 23 , 1851 (2023). https://doi.org/10.1186/s12889-023-16718-0

Download citation

Received : 07 March 2022

Accepted : 07 September 2023

Published : 23 September 2023

DOI : https://doi.org/10.1186/s12889-023-16718-0

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Maternal health
• Complex intervention
• Intervention implementation

BMC Public Health

ISSN: 1471-2458

• Submission enquiries: [email protected]
• General enquiries: [email protected]