presenting case study findings

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Blog Business

How to Present a Case Study like a Pro (With Examples)

By Danesh Ramuthi , Sep 07, 2023

Okay, let’s get real: case studies can be kinda snooze-worthy. But guess what? They don’t have to be!

In this article, I will cover every element that transforms a mere report into a compelling case study, from selecting the right metrics to using persuasive narrative techniques.

And if you’re feeling a little lost, don’t worry! There are cool tools like Venngage’s Case Study Creator to help you whip up something awesome, even if you’re short on time. Plus, the pre-designed case study templates are like instant polish because let’s be honest, everyone loves a shortcut.

Click to jump ahead: 

What is a case study presentation?

What is the purpose of presenting a case study, how to structure a case study presentation, how long should a case study presentation be, 5 case study presentation examples with templates, 6 tips for delivering an effective case study presentation, 5 common mistakes to avoid in a case study presentation, how to present a case study faqs.

A case study presentation involves a comprehensive examination of a specific subject, which could range from an individual, group, location, event, organization or phenomenon.

They’re like puzzles you get to solve with the audience, all while making you think outside the box.

Unlike a basic report or whitepaper, the purpose of a case study presentation is to stimulate critical thinking among the viewers. 

The primary objective of a case study is to provide an extensive and profound comprehension of the chosen topic. You don’t just throw numbers at your audience. You use examples and real-life cases to make you think and see things from different angles.

The primary purpose of presenting a case study is to offer a comprehensive, evidence-based argument that informs, persuades and engages your audience.

Here’s the juicy part: presenting that case study can be your secret weapon. Whether you’re pitching a groundbreaking idea to a room full of suits or trying to impress your professor with your A-game, a well-crafted case study can be the magic dust that sprinkles brilliance over your words.

Think of it like digging into a puzzle you can’t quite crack . A case study lets you explore every piece, turn it over and see how it fits together. This close-up look helps you understand the whole picture, not just a blurry snapshot.

It’s also your chance to showcase how you analyze things, step by step, until you reach a conclusion. It’s all about being open and honest about how you got there.

Besides, presenting a case study gives you an opportunity to connect data and real-world scenarios in a compelling narrative. It helps to make your argument more relatable and accessible, increasing its impact on your audience.

One of the contexts where case studies can be very helpful is during the job interview. In some job interviews, you as candidates may be asked to present a case study as part of the selection process.

Having a case study presentation prepared allows the candidate to demonstrate their ability to understand complex issues, formulate strategies and communicate their ideas effectively.

The way you present a case study can make all the difference in how it’s received. A well-structured presentation not only holds the attention of your audience but also ensures that your key points are communicated clearly and effectively.

In this section, let’s go through the key steps that’ll help you structure your case study presentation for maximum impact.

Let’s get into it. 

Open with an introductory overview 

Start by introducing the subject of your case study and its relevance. Explain why this case study is important and who would benefit from the insights gained. This is your opportunity to grab your audience’s attention.

Explain the problem in question

Dive into the problem or challenge that the case study focuses on. Provide enough background information for the audience to understand the issue. If possible, quantify the problem using data or metrics to show the magnitude or severity.

Detail the solutions to solve the problem

After outlining the problem, describe the steps taken to find a solution. This could include the methodology, any experiments or tests performed and the options that were considered. Make sure to elaborate on why the final solution was chosen over the others.

Key stakeholders Involved

Talk about the individuals, groups or organizations that were directly impacted by or involved in the problem and its solution. 

Stakeholders may experience a range of outcomes—some may benefit, while others could face setbacks.

For example, in a business transformation case study, employees could face job relocations or changes in work culture, while shareholders might be looking at potential gains or losses.

Discuss the key results & outcomes

Discuss the results of implementing the solution. Use data and metrics to back up your statements. Did the solution meet its objectives? What impact did it have on the stakeholders? Be honest about any setbacks or areas for improvement as well.

Include visuals to support your analysis

Visual aids can be incredibly effective in helping your audience grasp complex issues. Utilize charts, graphs, images or video clips to supplement your points. Make sure to explain each visual and how it contributes to your overall argument.

Pie charts illustrate the proportion of different components within a whole, useful for visualizing market share, budget allocation or user demographics.

This is particularly useful especially if you’re displaying survey results in your case study presentation.

Stacked charts on the other hand are perfect for visualizing composition and trends. This is great for analyzing things like customer demographics, product breakdowns or budget allocation in your case study.

Consider this example of a stacked bar chart template. It provides a straightforward summary of the top-selling cake flavors across various locations, offering a quick and comprehensive view of the data.

Not the chart you’re looking for? Browse Venngage’s gallery of chart templates to find the perfect one that’ll captivate your audience and level up your data storytelling.

Recommendations and next steps

Wrap up by providing recommendations based on the case study findings. Outline the next steps that stakeholders should take to either expand on the success of the project or address any remaining challenges.

Acknowledgments and references

Thank the people who contributed to the case study and helped in the problem-solving process. Cite any external resources, reports or data sets that contributed to your analysis.

Feedback & Q&A session

Open the floor for questions and feedback from your audience. This allows for further discussion and can provide additional insights that may not have been considered previously.

Closing remarks

Conclude the presentation by summarizing the key points and emphasizing the takeaways. Thank your audience for their time and participation and express your willingness to engage in further discussions or collaborations on the subject.

Well, the length of a case study presentation can vary depending on the complexity of the topic and the needs of your audience. However, a typical business or academic presentation often lasts between 15 to 30 minutes. 

This time frame usually allows for a thorough explanation of the case while maintaining audience engagement. However, always consider leaving a few minutes at the end for a Q&A session to address any questions or clarify points made during the presentation.

When it comes to presenting a compelling case study, having a well-structured template can be a game-changer. 

It helps you organize your thoughts, data and findings in a coherent and visually pleasing manner. 

Not all case studies are created equal and different scenarios require distinct approaches for maximum impact. 

To save you time and effort, I have curated a list of 5 versatile case study presentation templates, each designed for specific needs and audiences. 

Here are some best case study presentation examples that showcase effective strategies for engaging your audience and conveying complex information clearly.

1 . Lab report case study template

Ever feel like your research gets lost in a world of endless numbers and jargon? Lab case studies are your way out!

Think of it as building a bridge between your cool experiment and everyone else. It’s more than just reporting results – it’s explaining the “why” and “how” in a way that grabs attention and makes sense.

This lap report template acts as a blueprint for your report, guiding you through each essential section (introduction, methods, results, etc.) in a logical order.

Want to present your research like a pro? Browse our research presentation template gallery for creative inspiration!

2. Product case study template

It’s time you ditch those boring slideshows and bullet points because I’ve got a better way to win over clients: product case study templates.

Instead of just listing features and benefits, you get to create a clear and concise story that shows potential clients exactly what your product can do for them. It’s like painting a picture they can easily visualize, helping them understand the value your product brings to the table.

Grab the template below, fill in the details, and watch as your product’s impact comes to life!

3. Content marketing case study template

In digital marketing, showcasing your accomplishments is as vital as achieving them. 

A well-crafted case study not only acts as a testament to your successes but can also serve as an instructional tool for others. 

With this coral content marketing case study template—a perfect blend of vibrant design and structured documentation, you can narrate your marketing triumphs effectively.

4. Case study psychology template

Understanding how people tick is one of psychology’s biggest quests and case studies are like magnifying glasses for the mind. They offer in-depth looks at real-life behaviors, emotions and thought processes, revealing fascinating insights into what makes us human.

Writing a top-notch case study, though, can be a challenge. It requires careful organization, clear presentation and meticulous attention to detail. That’s where a good case study psychology template comes in handy.

Think of it as a helpful guide, taking care of formatting and structure while you focus on the juicy content. No more wrestling with layouts or margins – just pour your research magic into crafting a compelling narrative.

5. Lead generation case study template

Lead generation can be a real head-scratcher. But here’s a little help: a lead generation case study.

Think of it like a friendly handshake and a confident resume all rolled into one. It’s your chance to showcase your expertise, share real-world successes and offer valuable insights. Potential clients get to see your track record, understand your approach and decide if you’re the right fit.

No need to start from scratch, though. This lead generation case study template guides you step-by-step through crafting a clear, compelling narrative that highlights your wins and offers actionable tips for others. Fill in the gaps with your specific data and strategies, and voilà! You’ve got a powerful tool to attract new customers.

Related: 15+ Professional Case Study Examples [Design Tips + Templates]

So, you’ve spent hours crafting the perfect case study and are now tasked with presenting it. Crafting the case study is only half the battle; delivering it effectively is equally important. 

Whether you’re facing a room of executives, academics or potential clients, how you present your findings can make a significant difference in how your work is received. 

Forget boring reports and snooze-inducing presentations! Let’s make your case study sing. Here are some key pointers to turn information into an engaging and persuasive performance:

• Know your audience : Tailor your presentation to the knowledge level and interests of your audience. Remember to use language and examples that resonate with them.
• Rehearse : Rehearsing your case study presentation is the key to a smooth delivery and for ensuring that you stay within the allotted time. Practice helps you fine-tune your pacing, hone your speaking skills with good word pronunciations and become comfortable with the material, leading to a more confident, conversational and effective presentation.
• Start strong : Open with a compelling introduction that grabs your audience’s attention. You might want to use an interesting statistic, a provocative question or a brief story that sets the stage for your case study.
• Be clear and concise : Avoid jargon and overly complex sentences. Get to the point quickly and stay focused on your objectives.
• Use visual aids : Incorporate slides with graphics, charts or videos to supplement your verbal presentation. Make sure they are easy to read and understand.
• Tell a story : Use storytelling techniques to make the case study more engaging. A well-told narrative can help you make complex data more relatable and easier to digest.

Ditching the dry reports and slide decks? Venngage’s case study templates let you wow customers with your solutions and gain insights to improve your business plan. Pre-built templates, visual magic and customer captivation – all just a click away. Go tell your story and watch them say “wow!”

Nailed your case study, but want to make your presentation even stronger? Avoid these common mistakes to ensure your audience gets the most out of it:

Overloading with information

A case study is not an encyclopedia. Overloading your presentation with excessive data, text or jargon can make it cumbersome and difficult for the audience to digest the key points. Stick to what’s essential and impactful. Need help making your data clear and impactful? Our data presentation templates can help! Find clear and engaging visuals to showcase your findings.

Lack of structure

Jumping haphazardly between points or topics can confuse your audience. A well-structured presentation, with a logical flow from introduction to conclusion, is crucial for effective communication.

Ignoring the audience

Different audiences have different needs and levels of understanding. Failing to adapt your presentation to your audience can result in a disconnect and a less impactful presentation.

Poor visual elements

While content is king, poor design or lack of visual elements can make your case study dull or hard to follow. Make sure you use high-quality images, graphs and other visual aids to support your narrative.

Not focusing on results

A case study aims to showcase a problem and its solution, but what most people care about are the results. Failing to highlight or adequately explain the outcomes can make your presentation fall flat.

How to start a case study presentation?

Starting a case study presentation effectively involves a few key steps:

• Grab attention : Open with a hook—an intriguing statistic, a provocative question or a compelling visual—to engage your audience from the get-go.
• Set the stage : Briefly introduce the subject, context and relevance of the case study to give your audience an idea of what to expect.
• Outline objectives : Clearly state what the case study aims to achieve. Are you solving a problem, proving a point or showcasing a success?
• Agenda : Give a quick outline of the key sections or topics you’ll cover to help the audience follow along.
• Set expectations : Let your audience know what you want them to take away from the presentation, whether it’s knowledge, inspiration or a call to action.

How to present a case study on PowerPoint and on Google Slides?

Presenting a case study on PowerPoint and Google Slides involves a structured approach for clarity and impact using presentation slides :

• Title slide : Start with a title slide that includes the name of the case study, your name and any relevant institutional affiliations.
• Introduction : Follow with a slide that outlines the problem or situation your case study addresses. Include a hook to engage the audience.
• Objectives : Clearly state the goals of the case study in a dedicated slide.
• Findings : Use charts, graphs and bullet points to present your findings succinctly.
• Analysis : Discuss what the findings mean, drawing on supporting data or secondary research as necessary.
• Conclusion : Summarize key takeaways and results.
• Q&A : End with a slide inviting questions from the audience.

What’s the role of analysis in a case study presentation?

The role of analysis in a case study presentation is to interpret the data and findings, providing context and meaning to them. 

It helps your audience understand the implications of the case study, connects the dots between the problem and the solution and may offer recommendations for future action.

Is it important to include real data and results in the presentation?

Yes, including real data and results in a case study presentation is crucial to show experience,  credibility and impact. Authentic data lends weight to your findings and conclusions, enabling the audience to trust your analysis and take your recommendations more seriously

How do I conclude a case study presentation effectively?

To conclude a case study presentation effectively, summarize the key findings, insights and recommendations in a clear and concise manner. 

End with a strong call-to-action or a thought-provoking question to leave a lasting impression on your audience.

What’s the best way to showcase data in a case study presentation ?

The best way to showcase data in a case study presentation is through visual aids like charts, graphs and infographics which make complex information easily digestible, engaging and creative. 

Don’t just report results, visualize them! This template for example lets you transform your social media case study into a captivating infographic that sparks conversation.

Choose the type of visual that best represents the data you’re showing; for example, use bar charts for comparisons or pie charts for parts of a whole. 

Ensure that the visuals are high-quality and clearly labeled, so the audience can quickly grasp the key points. 

Keep the design consistent and simple, avoiding clutter or overly complex visuals that could distract from the message.

Choose a template that perfectly suits your case study where you can utilize different visual aids for maximum impact. 

Need more inspiration on how to turn numbers into impact with the help of infographics? Our ready-to-use infographic templates take the guesswork out of creating visual impact for your case studies with just a few clicks.

Related: 10+ Case Study Infographic Templates That Convert

Congrats on mastering the art of compelling case study presentations! This guide has equipped you with all the essentials, from structure and nuances to avoiding common pitfalls. You’re ready to impress any audience, whether in the boardroom, the classroom or beyond.

And remember, you’re not alone in this journey. Venngage’s Case Study Creator is your trusty companion, ready to elevate your presentations from ordinary to extraordinary. So, let your confidence shine, leverage your newly acquired skills and prepare to deliver presentations that truly resonate.

Go forth and make a lasting impact!

Home Blog Business How to Present a Case Study: Examples and Best Practices

How to Present a Case Study: Examples and Best Practices

Marketers, consultants, salespeople, and all other types of business managers often use case study analysis to highlight a success story, showing how an exciting problem can be or was addressed. But how do you create a compelling case study and then turn it into a memorable presentation? Get a lowdown from this post! 

Table of Content s

• Why Case Studies are a Popular Marketing Technique 

Popular Case Study Format Types

How to write a case study: a 4-step framework, how to do a case study presentation: 3 proven tips, how long should a case study be, final tip: use compelling presentation visuals, business case study examples, what is a case study .

Let’s start with this great case study definition by the University of South Caroline:

In the social sciences, the term case study refers to both a method of analysis and a specific research design for examining a problem, both of which can generalize findings across populations.

In simpler terms — a case study is investigative research into a problem aimed at presenting or highlighting solution(s) to the analyzed issues.

A standard business case study provides insights into:

• General business/market conditions 
• The main problem faced 
• Methods applied 
• The outcomes gained using a specific tool or approach

Case studies (also called case reports) are also used in clinical settings to analyze patient outcomes outside of the business realm. 

But this is a topic for another time. In this post, we’ll focus on teaching you how to write and present a business case, plus share several case study PowerPoint templates and design tips! 

Why Case Studies are a Popular Marketing Technique 

Besides presenting a solution to an internal issue, case studies are often used as a content marketing technique . According to a 2020 Content Marketing Institute report, 69% of B2B marketers use case studies as part of their marketing mix.

A case study informs the reader about a possible solution and soft-sells the results, which can be achieved with your help (e.g., by using your software or by partnering with your specialist). 

For the above purpose, case studies work like a charm. Per the same report: 

• For 9% of marketers, case studies are also the best method for nurturing leads. 
• 23% admit that case studies are beneficial for improving conversions. 

Moreover, case studies also help improve your brand’s credibility, especially in the current fake news landscape and dubious claims made without proper credit. 

Ultimately, case studies naturally help build up more compelling, relatable stories and showcase your product benefits through the prism of extra social proof, courtesy of the case study subject. 

Most case studies come either as a slide deck or as a downloadable PDF document. 

Typically, you have several options to distribute your case study for maximum reach:

• Case study presentations — in-person, virtual, or pre-recorded, there are many times when a case study presentation comes in handy. For example, during client workshops, sales pitches, networking events, conferences, trade shows, etc. 
• Dedicated website page — highlighting case study examples on your website is a great way to convert middle-on-the-funnel prospects. Google’s Think With Google case study section is a great example of a web case study design done right.

• Blog case studies — data-driven storytelling is a staunch way to stand apart from your competition by providing unique insights, no other brand can tell. 
• Video case studies — video is a great medium for showcasing more complex business cases and celebrating customer success stories.

Once you decide on your case study format, the next step is collecting data and then translating it into a storyline. There are different case study methods and research approaches you can use to procure data. 

But let’s say you already have all your facts straight and need to organize them in a clean copy for your presentation deck. Here’s how you should do it. 

1. Identify the Problem 

Every compelling case study research starts with a problem statement definition. While in business settings, there’s no need to explain your methodology in-depth; you should still open your presentation with a quick problem recap slide.

Be sure to mention: 

• What’s the purpose of the case study? What will the audience learn? 
• Set the scene. Explain the before, aka the problems someone was facing. 
• Advertise the main issues and findings without highlighting specific details.

The above information should nicely fit in several paragraphs or 2-3 case study template slides

2. Explain the Solution 

The bulk of your case study copy and presentation slides should focus on the provided solution(s). This is the time to speak at length about how the subject went from before to the glorious after. 

Here are some writing prompts to help you articulate this better:

• State the subject’s main objective and goals. What outcomes were they after?
• Explain the main solution(s) provided. What was done? Why this, but not that? 
• Mention if they tried any alternatives. Why did those work? Why were you better?

This part may take the longest to write. Don’t rush it and reiterate several times. Sprinkle in some powerful words and catchphrases to make your copy more compelling.

3. Collect Testimonials 

Persuasive case studies feature the voice of customer (VoC) data — first-party testimonials and assessments of how well the solution works. These provide extra social proof and credibility to all the claims you are making. 

So plan and schedule interviews with your subjects to collect their input and testimonials. Also, design your case study interview questions in a way that lets you obtain quantifiable results.

4. Package The Information in a Slide Deck

Once you have a rough first draft, try different business case templates and designs to see how these help structure all the available information. 

As a rule of thumb, try to keep one big idea per slide. If you are talking about a solution, first present the general bullet points. Then give each solution a separate slide where you’ll provide more context and perhaps share some quantifiable results.

For example, if you look at case study presentation examples from AWS like this one about Stripe , you’ll notice that the slide deck has few texts and really focuses on the big picture, while the speaker provides extra context.

Need some extra case study presentation design help? Download our Business Case Study PowerPoint template with 100% editable slides. 

Your spoken presentation (and public speaking skills ) are equally if not more important than the case study copy and slide deck. To make a strong business case, follow these quick techniques. 

Focus on Telling a Great Story

A case study is a story of overcoming a challenge, and achieving something grand. Your delivery should reflect that. Step away from the standard “features => benefits” sales formula. Instead, make your customer the hero of the study. Describe the road they went through and how you’ve helped them succeed. 

The premises of your story can be as simple as:

• Help with overcoming a hurdle
• Gaining major impact
• Reaching a new milestone
• Solving a persisting issue no one else code 

Based on the above, create a clear story arc. Show where your hero started. Then explain what type of journey they went through. Inject some emotions into the mix to make your narrative more relatable and memorable. 

Experiment with Copywriting Formulas 

Copywriting is the art and science of organizing words into compelling and persuasive combinations that help readers retain the right ideas. 

To ensure that the audience retains the right takeaways from your case study presentation, you can try using some of the classic copywriting formulas to structure your delivery. These include:

• AIDCA — short for A ttention, I nterest, D esire, C onviction, and A ction. First, grab the audience’s attention by addressing the major problem. Next, pique their interest with some teaser facts. Spark their desire by showing that you know the right way out. Then, show a conviction that you know how to solve the issue—finally, prompt follow-up action such as contacting you to learn more. 
• PADS — is short for Problem, Agitation, Discredit, or Solution. This is more of a sales approach to case study narration. Again, you start with a problem, agitate about its importance, discredit why other solutions won’t cut it, and then present your option. 
• 4Ps — short for P roblem, P romise, P roof, P roposal. This is a middle-ground option that prioritizes storytelling over hard pitches. Set the scene first with a problem. Then make a promise of how you can solve it. Show proof in the form of numbers, testimonials, and different scenarios. Round it up with a proposal for getting the same outcomes. 

Take an Emotion-Inducing Perspective

The key to building a strong rapport with an audience is showing that you are one of them and fully understand what they are going through. 

One of the ways to build this connection is by speaking from an emotion-inducing perspective. This is best illustrated with an example: 

• A business owner went to the bank
• A business owner came into a bank branch 

In the second case, the wording prompts listeners to paint a mental picture from the perspective of the bank employees — a role you’d like them to relate to. By placing your audience in the right visual perspective, you can make them more receptive to your pitches. 

One common question that arises when creating a case study is determining its length. The length of a case study can vary depending on the complexity of the problem and the level of detail you want to provide. Here are some general guidelines to help you decide how long your case study should be:

• Concise and Informative: A good case study should be concise and to the point. Avoid unnecessary fluff and filler content. Focus on providing valuable information and insights.
• Tailor to Your Audience: Consider your target audience when deciding the length. If you’re presenting to a technical audience, you might include more in-depth technical details. For a non-technical audience, keep it more high-level and accessible.
• Cover Key Points: Ensure that your case study covers the key points effectively. These include the problem statement, the solution, and the outcomes. Provide enough information for the reader to understand the context and the significance of your case.
• Visuals: Visual elements such as charts, graphs, images, and diagrams can help convey information more effectively. Use visuals to supplement your written content and make complex information easier to understand.
• Engagement: Keep your audience engaged. A case study that is too long may lose the reader’s interest. Make sure the content is engaging and holds the reader’s attention throughout.
• Consider the Format: Depending on the format you choose (e.g., written document, presentation, video), the ideal length may vary. For written case studies, aim for a length that can be easily read in one sitting.

In general, a written case study for business purposes often falls in the range of 1,000 to 2,000 words. However, this is not a strict rule, and the length can be shorter or longer based on the factors mentioned above.

Our brain is wired to process images much faster than text. So when you are presenting a case study, always look for an opportunity to tie in some illustrations such as: 

• A product demo/preview
• Processes chart 
• Call-out quotes or numbers
• Custom illustrations or graphics 
• Customer or team headshots 

Use icons to minimize the volume of text. Also, opt for readable fonts that can look good in a smaller size too.

To better understand how to create an effective business case study, let’s explore some examples of successful case studies:

Apple Inc.: Apple’s case study on the launch of the iPhone is a classic example. It covers the problem of a changing mobile phone market, the innovative solution (the iPhone), and the outstanding outcomes, such as market dominance and increased revenue.

Tesla, Inc.: Tesla’s case study on electric vehicles and sustainable transportation is another compelling example. It addresses the problem of environmental concerns and the need for sustainable transportation solutions. The case study highlights Tesla’s electric cars as the solution and showcases the positive impact on reducing carbon emissions.

Amazon.com: Amazon’s case study on customer-centricity is a great illustration of how the company transformed the e-commerce industry. It discusses the problem of customer dissatisfaction with traditional retail, Amazon’s customer-focused approach as the solution, and the remarkable outcomes in terms of customer loyalty and market growth.

Coca-Cola: Coca-Cola’s case study on brand evolution is a valuable example. It outlines the challenge of adapting to changing consumer preferences and demographics. The case study demonstrates how Coca-Cola continually reinvented its brand to stay relevant and succeed in the global market.

Airbnb: Airbnb’s case study on the sharing economy is an intriguing example. It addresses the problem of travelers seeking unique and affordable accommodations. The case study presents Airbnb’s platform as the solution and highlights its impact on the hospitality industry and the sharing economy.

These examples showcase the diversity of case studies in the business world and how they effectively communicate problems, solutions, and outcomes. When creating your own business case study, use these examples as inspiration and tailor your approach to your specific industry and target audience.

Finally, practice your case study presentation several times — solo and together with your team — to collect feedback and make last-minute refinements! 

1. Business Case Study PowerPoint Template

To efficiently create a Business Case Study it’s important to ask all the right questions and document everything necessary, therefore this PowerPoint Template will provide all the sections you need.

Use This Template

2. Medical Case Study PowerPoint Template

3. Medical Infographics PowerPoint Templates

4. Success Story PowerPoint Template

5. Detective Research PowerPoint Template

6. Animated Clinical Study PowerPoint Templates

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9 Creative Case Study Presentation Examples & Templates

Learn from proven case study presentation examples and best practices how to get creative, stand out, engage your audience, excite action, and drive results.

9 minute read

helped business professionals at:

Short answer

What makes a good case study presentation?

A good case study presentation has an engaging story, a clear structure, real data, visual aids, client testimonials, and a strong call to action. It informs and inspires, making the audience believe they can achieve similar results.

Dull case studies can cost you clients.

A boring case study presentation doesn't just risk putting your audience to sleep—it can actually stifle your growth, leading to lost sales and overlooked opportunities. When your case study fails to inspire, it's your bottom line that suffers.

Interactive elements are the secret sauce for successful case study presentations.

They not only increase reader engagement by 22% but also lead to a whopping 41% more decks being read fully, proving that the winning deck is not a monologue but a conversation that involves the reader.

Benefits of including interactive elements in your case study presentation

More decks read in full

Longer average reading time

In this post, I’ll help you shape your case studies into compelling narratives that hook your audience, make your successes shine, and drive the results you're aiming for.

Let’s go!

How to create a case study presentation that drives results?

Crafting a case study presentation that truly drives results is about more than just data—it's about storytelling, engagement, and leading your audience down the sales funnel.

Here's how you can do it:

Tell a story: Each case study should follow a narrative arc. Start with the problem, introduce your solution, and showcase the results. Make it compelling and relatable.

Leverage data: Hard numbers build credibility. Use them to highlight your successes and reinforce your points.

Use visuals: Images, infographics, and videos can enhance engagement, making complex information more digestible and memorable.

Add interactive elements: Make your presentation a two-way journey. Tools like tabs and live data calculators can increase time spent on your deck by 22% and the number of full reads by 41% .

Finish with a strong call-to-action: Every good story needs a conclusion. Encourage your audience to take the next step in their buyer journey with a clear, persuasive call-to-action.

Here's a visual representation of what a successful case study presentation should do:

How to write an engaging case study presentation?

Creating an engaging case study presentation involves strategic storytelling, understanding your audience, and sparking action. In this guide, I'll cover the essentials to help you write a compelling narrative that drives results.

What is the best format for a business case study presentation?

4 best format types for a business case study presentation:

• Problem-solution case study
• Before-and-after case study
• Success story case study
• Interview style case study

Each style has unique strengths, so pick one that aligns best with your story and audience. For a deeper dive into these formats, check out our detailed blog post on case study format types .

I also recommend watching this video breaking down the 9-step process for writing a case study:

What to include in a case study presentation?

An effective case study presentation contains 7 key elements:

• Introduction
• Company overview
• The problem/challenge
• Your solution
• Customer quotes/testimonials

To learn more about what should go in each of these sections, check out our post on what is a case study .

How to write a compelling narrative for your case study presentation?

Storytelling is the heart of an engaging case study presentation. It involves more than just stringing events together. You should weave an emotional journey that your audience can relate to.

Begin with the challenge —illustrate the magnitude of the problem that was faced. Then, introduce your solution as the hero that comes to the rescue.

As you progress, ensure your narrative highlights the transformative journey from the problem state to the successful outcome.

Here’s our recommended storyline framework:

How to motivate readers to take action?

Based on BJ Fogg's behavior model , successful motivation involves 3 components:

Motivation is all about highlighting the benefits. Paint a vivid picture of the transformative results achieved using your solution. Use compelling data and emotive testimonials to amplify the desire for similar outcomes, therefore boosting your audience's motivation.

Ability refers to making the desired action easy to perform. Show how straightforward it is to implement your solution. Use clear language, break down complex ideas, and reinforce the message that success is not just possible, but also readily achievable with your offering.

Prompt is your powerful call-to-action (CTA), the spark that nudges your audience to take the next step. Ensure your CTA is clear, direct, and tied into the compelling narrative you've built. It should leave your audience with no doubt about what to do next and why they should do it.

Here’s how you can do it with Storydoc:

How to adapt your presentation for your specific audience?

Every audience is different, and a successful case study presentation speaks directly to its audience's needs, concerns, and desires.

Understanding your audience is crucial. This involves researching their pain points, their industry jargon, their ambitions, and their fears.

Then, tailor your presentation accordingly. Highlight how your solution addresses their specific problems. Use language and examples they're familiar with. Show them how your product or service can help them reach their goals.

A case study presentation that's tailor-made for its audience is not just a presentation—it's a conversation that resonates, engages, and convinces.

How to design a great case study presentation?

A powerful case study presentation is not only about the story you weave—it's about the visual journey you create.

Let's navigate through the design strategies that can transform your case study presentation into a gripping narrative.

Add interactive elements

Static design has long been the traditional route for case study presentations—linear, unchanging, a one-size-fits-all solution.

However, this has been a losing approach for a while now. Static content is killing engagement, but interactive design will bring it back to life.

It invites your audience into an evolving, immersive experience, transforming them from passive onlookers into active participants.

Which of these presentations would you prefer to read?

Use narrated content design (scrollytelling)

Scrollytelling combines the best of scrolling and storytelling. This innovative approach offers an interactive narrated journey controlled with a simple scroll.

It lets you break down complex content into manageable chunks and empowers your audience to control their reading pace.

To make this content experience available to everyone, our founder, Itai Amoza, collaborated with visualization scientist Prof. Steven Franconeri to incorporate scrollytelling into Storydoc.

This collaboration led to specialized storytelling slides that simplify content and enhance engagement (which you can find and use in Storydoc).

Here’s an example of Storydoc scrollytelling:

Bring your case study to life with multimedia

Multimedia brings a dynamic dimension to your presentation. Video testimonials lend authenticity and human connection. Podcast interviews add depth and diversity, while live graphs offer a visually captivating way to represent data.

Each media type contributes to a richer, more immersive narrative that keeps your audience engaged from beginning to end.

Prioritize mobile-friendly design

In an increasingly mobile world, design must adapt. Avoid traditional, non-responsive formats like PPT, PDF, and Word.

Opt for a mobile-optimized design that guarantees your presentation is always at its best, regardless of the device.

As a significant chunk of case studies are opened on mobile, this ensures wider accessibility and improved user experience , demonstrating respect for your audience's viewing preferences.

Here’s what a traditional static presentation looks like as opposed to a responsive deck:

Streamline the design process

Creating a case study presentation usually involves wrestling with a website builder.

It's a dance that often needs several partners - designers to make it look good, developers to make it work smoothly, and plenty of time to bring it all together.

Building, changing, and personalizing your case study can feel like you're climbing a mountain when all you need is to cross a hill.

By switching to Storydoc’s interactive case study creator , you won’t need a tech guru or a design whizz, just your own creativity.

You’ll be able to create a customized, interactive presentation for tailored use in sales prospecting or wherever you need it without the headache of mobilizing your entire team.

Storydoc will automatically adjust any change to your presentation layout, so you can’t break the design even if you tried.

Case study presentation examples that engage readers

Let’s take a deep dive into some standout case studies.

These examples go beyond just sharing information – they're all about captivating and inspiring readers. So, let’s jump in and uncover the secret behind what makes them so effective.

What makes this deck great:

• A video on the cover slide will cause 32% more people to interact with your case study .
• The running numbers slide allows you to present the key results your solution delivered in an easily digestible way.
• The ability to include 2 smart CTAs gives readers the choice between learning more about your solution and booking a meeting with you directly.

Light mode case study

• The ‘read more’ button is perfect if you want to present a longer case without overloading readers with walls of text.
• The timeline slide lets you present your solution in the form of a compelling narrative.
• A combination of text-based and visual slides allows you to add context to the main insights.

Marketing case study

• Tiered slides are perfect for presenting multiple features of your solution, particularly if they’re relevant to several use cases.
• Easily customizable slides allow you to personalize your case study to specific prospects’ needs and pain points.
• The ability to embed videos makes it possible to show your solution in action instead of trying to describe it purely with words.

UX case study

• Various data visualization components let you present hard data in a way that’s easier to understand and follow.
• The option to hide text under a 'Read more' button is great if you want to include research findings or present a longer case study.
• Content segmented using tabs , which is perfect if you want to describe different user research methodologies without overwhelming your audience.

Business case study

• Library of data visualization elements to choose from comes in handy for more data-heavy case studies.
• Ready-to-use graphics and images which can easily be replaced using our AI assistant or your own files.
• Information on the average reading time in the cover reduces bounce rate by 24% .

Modern case study

• Dynamic variables let you personalize your deck at scale in just a few clicks.
• Logo placeholder that can easily be replaced with your prospect's logo for an added personal touch.
• Several text placeholders that can be tweaked to perfection with the help of our AI assistant to truly drive your message home.

Real estate case study

• Plenty of image placeholders that can be easily edited in a couple of clicks to let you show photos of your most important listings.
• Data visualization components can be used to present real estate comps or the value of your listings for a specific time period.
• Interactive slides guide your readers through a captivating storyline, which is key in a highly-visual industry like real estate .

Medical case study

• Image and video placeholders are perfect for presenting your solution without relying on complex medical terminology.
• The ability to hide text under an accordion allows you to include research or clinical trial findings without overwhelming prospects with too much information.
• Clean interactive design stands out in a sea of old-school medical case studies, making your deck more memorable for prospective clients.

Dark mode case study

• The timeline slide is ideal for guiding readers through an attention-grabbing storyline or explaining complex processes.
• Dynamic layout with multiple image and video placeholders that can be replaced in a few clicks to best reflect the nature of your business.
• Testimonial slides that can easily be customized with quotes by your past customers to legitimize your solution in the eyes of prospects.

Grab a case study presentation template

Creating an effective case study presentation is not just about gathering data and organizing it in a document. You need to weave a narrative, create an impact, and most importantly, engage your reader.

So, why start from zero when interactive case study templates can take you halfway up?

Instead of wrestling with words and designs, pick a template that best suits your needs, and watch your data transform into an engaging and inspiring story.

Hi, I'm Dominika, Content Specialist at Storydoc. As a creative professional with experience in fashion, I'm here to show you how to amplify your brand message through the power of storytelling and eye-catching visuals.

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Case study presentation: A comprehensive guide

This comprehensive guide covers everything from the right topic to designing your slides and delivering your presentation.

Raja Bothra

Building presentations

Hey there, fellow content creators and business enthusiasts!

If you're looking to take your presentations to the next level, you've come to the right place.

In today's digital age, a powerful case study presentation is your secret weapon to leave a lasting impression on potential clients, colleagues, or stakeholders.

It's time to demystify the art of case study presentations and equip you with the knowledge to create compelling and persuasive slides that showcase your expertise.

What is a case study?

Before we jump into the nitty-gritty details of creating a compelling case study presentation, let's start with the basics. What exactly is a case study? A case study is a detailed analysis of a specific subject, often focusing on a real-world problem or situation. It serves as a valuable tool to showcase your expertise and the impact your solutions can have on real issues.

Case study presentations are not just reports; they are powerful storytelling tools designed to engage your audience and provide insights into your success stories. Whether you're a marketer, a salesperson, or an educator, knowing how to present a case study effectively can be a game-changer for your business.

Why is it important to have an effective case study presentation?

The importance of a well-crafted case study presentation cannot be overstated. It's not just about sharing information; it's about convincing your audience that your product or service is the solution they've been looking for. Here are a few reasons why case study presentations matter:

Generating leads and driving sales

Picture this: a potential customer is exploring your website, trying to figure out if your product or service is the right fit for their needs. An effective case study can be the clincher, demonstrating how your offering has guided other businesses to success. When prospects witness a proven track record of your product or service making a difference, they are more inclined to place their trust in you and forge a partnership. In essence, case studies can be the catalyst that transforms casual visitors into paying customers.

Building credibility and social proof

In the realm of business, credibility is akin to gold. A well-crafted case study is your gateway to establishing authority and unveiling the remarkable value you bring to the table. It's not just you saying you're the best; it's your satisfied clients proclaiming it through their experiences. Every compelling case study is a testimonial in itself, a testament to your capability to deliver tangible results. In essence, it's a vote of confidence from others in your field, and these votes can be a potent motivator for potential clients.

Educating and informing your target audience

Education is a cornerstone of building lasting relationships with your audience. Case studies are an invaluable tool for teaching potential clients about the merits of your product or service and how it can address their specific challenges. They're not just stories; they're lessons, revealing the real-world benefits of what you offer. By doing so, you position your company as a thought leader in your industry and cultivate trust among your audience. You're not just selling; you're empowering your audience with knowledge.

Increasing brand awareness

Your brand deserves to be in the spotlight. Case studies can serve as a beacon, promoting your brand and its offerings across a multitude of platforms. From your website to social media and email marketing, case studies help you amplify your brand's presence and appeal. As you increase your reach and visibility, you also draw the attention of new customers, who are eager to experience the success stories they've read about in your case studies.

Different types of case study presentation

Now that you understand why case study presentations are vital, let's explore the various types you can use to showcase your successes.

Business case studies presentation : Business case studies presentation focus on how your product or service has impacted a specific company or organization. These are essential tools for B2B companies, as they demonstrate the tangible benefits your solution brings to other businesses.

Marketing case studies presentation : If you're in the marketing game, you've probably come across these frequently. Marketing case studies dive into the strategies and tactics used to achieve specific marketing goals. They provide insights into successful campaigns and can be a great resource for other marketers.

Product case studies presentation : For companies that offer products, a product case study can be a game-changer. It shows potential clients how your product functions in the real world and why it's the best choice for them.

KPIs and metrics to add in case study presentation

When presenting a case study, you're not just telling a story; you're also showcasing the concrete results of your efforts. Numbers matter, and they can add significant credibility to your presentation. While there's a vast array of key performance indicators (KPIs) and metrics you can include, here are some that you should definitely consider:

Conversion rate : This metric is a reflection of how effective your product or service has been in driving conversions. It demonstrates the rate at which visitors take the desired actions, whether it's signing up for your newsletter, making a purchase, or any other valuable engagement.

ROI (return on investment) : It's the financial impact that counts, and ROI is the king of financial metrics. It's a clear indicator of how your solution has provided value, showing the return on the investment made by your client.

Engagement metrics : Engaging your audience is a vital part of the puzzle. Metrics like click-through rates and social media interactions reveal how effectively your solution has drawn people in and kept them engaged.

Customer satisfaction : A satisfied customer is a loyal customer. Showcase customer satisfaction scores or even better, let the clients themselves tell their stories through testimonials. These scores and testimonials are potent proof of your ability to meet and exceed expectations.

Sales growth : When applicable, include data on how your solution has catalyzed sales growth. Sales growth is a pivotal indicator of the practical, real-world impact of your product or service.

However, it's important to note that there are some general KPIs and metrics that are commonly used in case study presentations. These metrics are not only universal but also highly effective in conveying the success of your case study:

• Website traffic : The number of visitors to your website over a specified period is an important indicator of the reach and impact of your case study. It shows how many people were interested enough to seek more information.
• Conversion rate : This percentage reveals how successful your website is at converting visitors into taking a desired action. Whether it's signing up for a newsletter, making a purchase, or any other specific action, a high conversion rate signifies effective engagement.
• Customer lifetime value (CLV) : The CLV is a valuable metric, representing the average amount of money a customer spends with your company over their lifetime. It's a testament to the long-term value your product or service provides.
• Average order value (AOV) : The AOV showcases the average amount of money a customer spends in a single transaction. It's a metric that demonstrates the immediate value your solution offers.
• Net promoter score (NPS) : This customer satisfaction metric measures how likely your customers are to recommend your company to others. A high NPS indicates satisfied customers who can become advocates for your brand.

Incorporating these KPIs and metrics not only adds credibility to your case study presentation but also provides a well-rounded view of your success story. It's the data that speaks the loudest and validates the impact of your product or service.

How to structure an effective case study presentation

Structuring an effective case study presentation is essential for conveying information clearly and persuasively to your audience. Whether you're presenting to colleagues, clients, or students, a well-organized case study presentation can make a significant impact. Here are some key steps to structure your case study presentation effectively:

1. Introduction :

Start with a brief introduction that sets the stage for your case study. Explain the context, the purpose of the study, and the key objectives you aim to achieve. This section should pique the audience's interest and provide a clear understanding of what to expect.

2. Background and context :

Provide a comprehensive overview of the background and context of the case study. This might include the industry, company, or problem under consideration. Explain why the case study is relevant and the issues it addresses. Make sure your audience understands the "why" before delving into the details.

3. Problem statement :

Clearly define the problem or challenge that the case study focuses on. This is a critical element as it helps the audience grasp the significance of the issue at hand. Use data and evidence to support your claims and emphasize the real-world impact of the problem.

4. Methodology :

Describe the methods and approach you used to analyze the case. This section should outline your research process, data collection tools , and any methods or frameworks employed. It's important to demonstrate the rigor of your analysis and data sources.

5. Findings and analysis :

Present the key findings and insights from your case study. Use data, charts, graphs, and visuals to make the information more accessible and engaging. Discuss your analysis and provide explanations for the findings. It's crucial to show a deep understanding of the problem and its implications.

6. Solution or action plan :

Outline the solution, recommendations, or action plan you've developed based on your analysis. Explain the rationale behind your proposed solution and how it directly addresses the problem. Include implementation steps, timelines, and any potential obstacles.

7. Results and outcomes :

Highlight the results and outcomes of implementing your solution, if applicable. Use before-and-after comparisons, success metrics, and tangible achievements to illustrate the effectiveness of your recommendations. This helps demonstrate the real-world impact of your work.

8. Lessons learned :

Share any lessons learned from the case study. Discuss what worked well, what didn't, and any unexpected challenges. This reflective element shows that you can extract valuable insights from the experience.

9. Conclusion :

Summarize the key takeaways from your case study and restate its significance. Make a compelling case for the importance of the findings and the applicability of the solution in a broader context.

10. Recommendations and next steps :

Provide recommendations for the future, including any further actions that can be taken or additional research required. Give your audience a sense of what to do next based on the case study's insights.

11. Q&A and discussion :

Open the floor for questions and discussion. Encourage your audience to ask for clarification, share their perspectives, and engage in a constructive dialogue about the case study.

12. References and appendices :

Include a list of references, citations, and any supplementary materials in appendices that support your case study. This adds credibility to your presentation and allows interested individuals to delve deeper into the subject.

A well-structured case study presentation not only informs but also persuades your audience by providing a clear narrative and a logical flow of information. It is an opportunity to showcase your analytical skills, problem-solving abilities, and the value of your work in a practical setting.

Do’s and don'ts on a case study presentation

To ensure your case study presentation hits the mark, here's a quick rundown of some do's and don'ts:

• Use visual aids : Visual aids like charts and graphs can make complex data more digestible.
• Tell a story : Engage your audience by narrating a compelling story.
• Use persuasive language : Convincing your audience requires a persuasive tone.
• Include testimonials : Real-life experiences add authenticity to your presentation.
• Follow a format : Stick to a well-structured format for clarity.

Don'ts:

• Avoid jargon : Keep it simple and free from industry jargon.
• Don't oversell : Be honest about your product or service's capabilities.
• Don't make it too long : A concise presentation is more effective than a lengthy one.
• Don't overload with data : Focus on the most relevant and impactful data.

Summarizing key takeaways

• Understanding case studies : Case studies are detailed analyses of specific subjects, serving to showcase expertise and solution impact.
• Importance of effective case study presentations : They generate leads, build credibility, educate the audience, and increase brand awareness.
• Types of case study presentations : Business, marketing, and product case studies focus on different aspects of impact.
• KPIs and metrics : Key metrics, such as conversion rates, ROI, engagement metrics, customer satisfaction, and sales growth, add credibility.
• Structuring an effective case study presentation : Follow a structured format with an introduction, background, problem statement, methodology, findings, solution, results, lessons learned, conclusion, recommendations, and Q&A.
• Do's : Use visuals, tell a compelling story, use persuasive language, include testimonials, and follow a structured format.
• Don'ts: Use jargon, oversell, make it too long, or overload with unnecessary data.

1. How do I create a compelling case study presentation?

To create a compelling case study presentation, you can use a case study template that will help you structure your content in a clear and concise manner. You can also make use of a case study presentation template to ensure that your presentation slides are well-organized. Additionally, make your case study like a pro by using real-life examples and a professional case study format.

2. What is the best way to present a case study to prospective clients?

When presenting a case study to prospective clients, it's essential to use case study presentation template. This will help you present your findings in a persuasive way, just like a professional presentation. You can also use a powerpoint case study template to make your case study presentation in no time. The length of a case study can vary depending on the complexity, but a well-written case study is key to helping your clients understand the value.

3. Where can I find popular templates to use for my case study presentation?

You can find popular case study presentation powerpoint templates online. These templates are specifically designed to help you create a beautiful case study that will impress your audience. They often include everything you need to impress your audience, from the case study format to the presentation deck. Using templates you can use is one of the best ways to create a case study presentation in a professional and efficient manner.

4. What is the purpose of a case study in content marketing, and how can I use one effectively?

The purpose of a case study in content marketing is to showcase real-world examples of how your product or service has solved a problem or added value to clients. To use a case study effectively, write a case study that features a relevant case study example and use a case study like a pro to make your case. You can also embed your case study within your content marketing strategy to help your clients and prospective clients understand the value your business offers.

5. How can I ensure that my case study presentation stands out as the best in my industry?

To ensure your case study presentation stands out as the best, you can follow a compelling business case study design. Use a case study template that includes everything you need to present a compelling and successful case, just like PowerPoint case study presentations. Make sure your case study is clear and concise, and present it in a persuasive way. Using real-life examples and following the sections in your template can set your presentation apart from the rest, making it the best case study presentation in your field.

Create your case study presentation with prezent

Prezent, the communication success platform designed for enterprise teams, offers a host of valuable tools and features to assist in creating an impactful case study presentation.

• Brand-approved design : With access to over 35,000 slides in your company's brand-approved design, your case study presentation can maintain a consistent and professional look that aligns with your corporate brand and marketing guidelines.
• Structured storytelling : Prezent helps you master structured storytelling by offering 50+ storylines commonly used by business leaders. This ensures your case study presentation follows a compelling and coherent narrative structure.
• Time and cost efficiency : Prezent can save you valuable time and resources. It can help you save 70% of the time required to make presentations and reduce communication costs by 60%, making it a cost-effective solution for creating case study presentations.
• Enterprise-grade security : Your data's security is a top priority for Prezent. With independent third-party assurance, you can trust that your sensitive information remains protected while creating and sharing your case study presentation.

In summary, Prezent empowers you to create a compelling case study presentation by offering personalized audience insights, brand-compliant designs, structured storytelling support, real-time collaboration, efficiency gains, and robust data security. It's a comprehensive platform for achieving communication success in the world of enterprise presentations.

Are you ready to take your case study presentations to the next level?  Try our free trial or book a demo today with Prezent!

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Preparing the presentation of qualitative findings: considering your roles and goals

Dr. Philip Adu is a Methodology Expert at The Chicago School of Professional Psychology (TCSPP). In this post he explains the things to consider when presenting your research findings.

This post follows on from his previous blog post “Perfecting the art of qualitative coding” in which he took us through the stages of qualitative coding and, along the way, outlined the features he found most useful.

In my previous blog post, I presented on making good use of the innovative features of NVivo across the three main stages of qualitative analysis. Expounding on the third stage which is the ‘ Post-Coding stage (Presenting your findings) ’, I want to throw light on things to consider when drafting and refining your presentation. The moment you reach a milestone of successfully using NVivo 12 (Version 12.1.249; QSR International Pty Ltd, 2018) to complete the data analysis process, the reality of preparing all of this data so you can present your findings sets in (Adu, 2016). Your methodical review of the qualitative data and development of codes, categories and themes has yielded massive and interesting NVivo outputs. The outcomes include but are not limited to; codes/nodes, categories/themes, Word Clouds, Word Tree, Framework Matrices, Cluster Tree, code-case matrices, and code-attribute matrices (see Figure 1). These findings need to be carefully examined – selecting the ones that will be useful in drafting a meaningful presentation. You can watch the presentation I developed below:

Source: https://www.youtube.com/watch?v=xEyGGFtVQFw

Note, not all of this information (i.e. the outcomes) needs to be presented to your audience (see Adu, 2019 ). Other questions that may arise as you develop your presentation include; what kind of results should you present? How do you engage with your audience when presenting your findings? How would you help your audience to understand and believe your findings?

In this post, I will discuss the three pertinent components a good presentation of qualitative findings should have. They are; background information, data analysis process and main findings.

Figure 1. Presentation of findings

Presenting background information

Participants’ past and current situations influence the information they provide to you. Due to this, there is the need to provide readers a summary of who participants are and any background information which may help them to put the findings into the proper context. Also, as a researcher analyzing qualitative data, there is the likelihood of your own background impacting the data analysis process. In the same way, you need to let readers know who you are, what your background is and how you ‘bracketed’ them from not having an effect on the findings ( Adu, 2019 ).

Presenting the data analysis process

Qualitative analysis doesn’t only involve engaging in subjective development of codes and categories, but also promoting transparency in the coding and categorization process (Greckhamer & Cilesiz, 2014). Due to this, you are expected to describe the main and detailed steps you took to analyze your data to arrive at your findings and their respective outcomes. Addressing the following questions would be great:

• What coding strategy did you use?
• What kinds of codes did you assign to relevant excerpts of the data?
• What are the examples of codes you generated?
• What categorization technique did you use?
• How did you develop categories/themes out of the codes?

Your audience’s aim is not only consuming what you found but also learning more about how you came up with the results.

Presenting main findings

When it comes to the presentation of findings, there are two main structures you could choose from. You could present them based on the themes generated or based on the cases (participants or groups of participants) you have. The decision to either structure depends on the kind of research question(s) or the research purpose you have. For a detailed explanation of the types of presentation formats and how to select an appropriate structure, see Chapter 13 of the book, “ A Step-by-Step Guide to Qualitative Data Coding ”.

Considering your roles and goals

As you plan on how to communicate the above components, make sure you accomplish your goals and carry out your role as a communicator of qualitative data analysis outcomes (See Figure 1). Your roles are; to thoughtfully arrange the data analysis outcomes and to adequately address your research questions.

Liken the presentation of your findings to sharing a puzzle which has been solved. Your goal is to prevent a situation where the burden is put on the audience to piece together the puzzle of findings. In other words, you are expected to present the findings in a meaningful way that would enhance the audience’s understanding of the data analysis outcomes (Adu, 2016 & 2019). By so doing, they are more likely to trust what you found.

Let’s summarize the action items:

• Out of a pool of qualitative analysis outcomes, select the ones that would allow you to address your research questions and meaningfully communicate your findings.
• Decide on how you want to structure the presentation of the findings.
• Irrespective of the presentation format you choose, make sure you include background information, the data analysis process and main findings in your presentation.
• Make sure you are ‘narrating’ participants’ stories or what you found – making the numeric outputs include the tables and charts generated play a supporting role when presenting the main findings.

Adu, P. (2016). Presenting Qualitative Findings Using NVivo Output to Tell the Story. [PowerPoint slides]. SlideShare. Retrieved from https://www.slideshare.net/kontorphilip/presenting-qualitative-findings-using-nvivo-output-to-tell-the-story

QSR International Pty Ltd. (2018). NVivo 12. Version 12.1.249 [Computer software]. Retrieved from https://qsrinternational.com/nvivo-qualitative-data-analysis-software

Adu, P. (2019). A Step-by-Step Guide to Qualitative Data Coding . Oxford: Routledge

Greckhamer, T., & Cilesiz, S. (2014). Rigor, Transparency, Evidence, and Representation in Discourse Analysis: Challenges and Recommendations. International Journal of Qualitative Methods, 13(1), 422-443. doi:10.1177/160940691401300123

ABOUT THE AUTHOR

Dr. Philip Adu is a Methodology Expert at The Chicago School of Professional Psychology (TCSPP). His role is to provide support to dissertating students in TCSPP addressing their methodology related concerns. You could access some of his webinars at the ‘Methodology Related Presentations – TCSPP’ YouTube Channel. He completed his Doctoral degree in Education with a concentration in Learning, Instructional Design and Technology from West Virginia University (WVU). Dr. Adu recently authored a book titled, “A Step-by-Step Guide to Qualitative Data Coding” (available on routledge.com or amazon.com ). You could reach Dr. Adu at [email protected] and @drphilipadu on twitter.

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A complete guide to presenting UX research findings

In this complete guide to presenting UX research findings, we’ll cover what you should include in a UX research report, how to present UX research findings and tips for presenting your UX research.

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User experience research sets out to identify the problem that a product or service needs to solve and finds a way to do just that. Research is the first and most important step to optimising user experience.

UX researchers do this through interviews, surveys, focus groups, data analysis and reports. Reports are how UX researchers present their work to other stakeholders in a company, such as designers, developers and executives.

In this guide, we’ll cover what you should include in a UX research report, how to present UX research findings and tips for presenting your UX research.

Components of a UX research report

How to write a ux research report, 5 tips on presenting ux research findings.

Ready to present your research findings? Let’s dive in.

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There are six key components to a UX research report.

Introduction

The introduction should give an overview of your UX research . Then, relate any company goals or pain points to your research. Lastly, your introduction should briefly touch on how your research could affect the business.

Research goals

Simply put, your next slide or paragraph should outline the top decisions you need to make, the search questions you used, as well as your hypothesis and expectations.

Business value

In this section, you can tell your stakeholders why your research matters. If you base this research on team-level or product development goals, briefly touch on those.

Methodology

Share the research methods you used and why you chose those methods. Keep it concise and tailored to your audience. Your stakeholders probably don’t need to hear everything that went into your process.

Key learnings

This section will be the most substantial part of your report or presentation. Present your findings clearly and concisely. Share as much context as possible while keeping your target audience – your stakeholders – in mind.

Recommendations

In the last section of your report, make actionable recommendations for your stakeholders. Share possible solutions or answers to your research questions. Make your suggestions clear and consider any future research studies that you think would be helpful.

1. Define your audience

Most likely, you’ll already have conducted stakeholder interviews when you were planning your research. Taking those interviews into account, you should be able to glean what they’re expecting from your presentation.

Tailor your presentation to the types of findings that are most relevant, how those findings might affect their work and how they prefer to receive information. Only include information they will care about the most in a medium that’s easy for them to understand.

Do they have a technical understanding of what you’re doing or should you keep it a non-technical presentation? Make sure you keep the terminology and data on a level they can understand.

What part of the business do they work in? Executives will want to know about how it affects their business, while developers will want to know what technological changes they need to make.

2. Summarise

As briefly as possible, summarise your research goals, business value and methodology. You don’t need to go into too much detail for any of these items. Simply share the what, why and how of your research.

Answer these questions:

• What research questions did you use, and what was your hypothesis?
• What business decision will your research assist with?
• What methodology did you use?

You can briefly explain your methods to recruit participants, conduct interviews and analyse results. If you’d like more depth, link to interview plans, surveys, prototypes, etc.

3. Show key learnings

Your stakeholders will probably be pressed for time. They won’t be able to process raw data and they usually don’t want to see all of the work you’ve done. What they’re looking for are key insights that matter the most to them specifically. This is why it’s important to know your audience.

Summarise a few key points at the beginning of your report. The first thing they want to see are atomic research nuggets. Create condensed, high-priority bullet points that get immediate attention. This allows people to reference it quickly. Then, share relevant data or artefacts to illustrate your key learnings further.

Relevant data:

• Recurring trends and themes
• Relevant quotes that illustrate important findings
• Data visualisations

Relevant aspects of artefacts:

• Quotes from interviews
• User journey maps
• Affinity diagrams
• Storyboards

For most people you’ll present to, a summary of key insights will be enough. But, you can link to a searchable repository where they can dig deeper. You can include artefacts and tagged data for them to reference.

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4. Share insights and recommendations

Offer actionable recommendations, not opinions. Share clear next steps that solve pain points or answer pending decisions. If you have any in mind, suggest future research options too. If users made specific recommendations, share direct quotes.

5. Choose a format

There are two ways you could share your findings in a presentation or a report. Let’s look at these two categories and see which might be the best fit for you.

Usually, a presentation is best for sharing data with a large group and when presenting to non-technical stakeholders. Presentations should be used for visual communication and when you only need to include relevant information in a brief summary.

A presentation is usually formatted in a:

• Case studies
• Atomic research nuggets
• Pre-recorded video

If you’re presenting to a smaller group, technical stakeholder or other researchers, you might want to use a report. This gives you the capacity to create a comprehensive record. Further, reports could be categorised based on their purpose as usability, analytics or market research reports.

A report is typically formatted in a:

• Notion or Confluence page
• Slack update

You might choose to write a report first, then create a presentation. After the presentation, you can share a more in-depth report. The report could also be used for records later.

1. Keep it engaging

When you’re presenting your findings, find ways to engage those you’re presenting to. You can ask them questions about their assumptions or what you’re presenting to get them more involved.

For example, “What do you predict were our findings when we asked users to test the usability of the menu?” or “What suggestions do you think users had for [a design problem]?”

If you don’t want to engage them with questions, try including alternative formats like videos, audio clips, visualisations or high-fidelity prototypes. Anything that’s interactive or different will help keep their engagement. They might engage with these items during or after your presentation.

Another way to keep it engaging is to tell a story throughout your presentation. Some UX researchers structure their presentations in the form of Joseph Campbell’s Hero’s Journey . Start in the middle with your research findings and then zoom out to your summary, insights and recommendations.

2. Combine qualitative and quantitative data

When possible, use qualitative data to back up quantitative data. For example, include a visualisation of poll results with a direct quote about that pain point.

Use this opportunity to show the value of the work you do and build empathy for your users. Translate your findings into a format that your stakeholders – designers, developers or executives – will be able to understand and act upon.

3. Make it actionable

Actionable presentations are engaging and they should have some business value . That means they need to solve a problem or at least move toward a solution to a problem. They might intend to optimise usability, find out more about the market or analyse user data.

Here are a few ways to make it actionable:

• Include a to-do list at the end
• Share your deck and repository files for future reference
• Recommend solutions for product or business decisions
• Suggest what kind of research should happen next (if any)
• Share answers to posed research questions

4. Keep it concise and effective

Make it easy for stakeholders to dive deeper if they want to but make it optional. Yes, this means including links to an easily searchable repository and keeping your report brief.

Humans tend to focus best on just 3-4 things at a time. So, limit your report to three or four major insights. Additionally, try to keep your presentation down to 20-30 minutes.

Remember, you don’t need to share everything you learned. In your presentation, you just need to show your stakeholders what they are looking for. Anything else can be sent later in your repository or a more detailed PDF report.

5. Admit the shortcomings of UX research

If you get pushback from stakeholders during your presentation, it’s okay to share your constraints.

Your stakeholders might not understand that your sample size is big enough or how you chose the users in your study or why you did something the way you did. While qualitative research might not be statistically significant, it’s usually representative of your larger audience and it’s okay to point that out.

Because they aren’t researchers, it’s your job to explain your methodology to them but also be upfront about the limitations UX research can pose. When all of your cards are on the table, stakeholders are more likely to trust you.

When it comes to presenting your UX research findings, keep it brief and engaging. Provide depth with external resources after your presentation. This is how you get stakeholders to find empathy for your users. This is how you master the art of UX.

Need to go back to the basics and learn more about UX research? Dive into these articles:

What is UX research? The 9 best UX research tools to use in 2022

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Organizing Your Social Sciences Research Assignments

• Annotated Bibliography
• Analyzing a Scholarly Journal Article
• Group Presentations
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• Types of Structured Group Activities
• Group Project Survival Skills
• Leading a Class Discussion
• Multiple Book Review Essay
• Reviewing Collected Works
• Writing a Case Analysis Paper
• Writing a Case Study
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Reflective Paper
• Writing a Research Proposal
• Generative AI and Writing
• Acknowledgments

A case study research paper examines a person, place, event, condition, phenomenon, or other type of subject of analysis in order to extrapolate  key themes and results that help predict future trends, illuminate previously hidden issues that can be applied to practice, and/or provide a means for understanding an important research problem with greater clarity. A case study research paper usually examines a single subject of analysis, but case study papers can also be designed as a comparative investigation that shows relationships between two or more subjects. The methods used to study a case can rest within a quantitative, qualitative, or mixed-method investigative paradigm.

Case Studies. Writing@CSU. Colorado State University; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010 ; “What is a Case Study?” In Swanborn, Peter G. Case Study Research: What, Why and How? London: SAGE, 2010.

How to Approach Writing a Case Study Research Paper

General information about how to choose a topic to investigate can be found under the " Choosing a Research Problem " tab in the Organizing Your Social Sciences Research Paper writing guide. Review this page because it may help you identify a subject of analysis that can be investigated using a case study design.

However, identifying a case to investigate involves more than choosing the research problem . A case study encompasses a problem contextualized around the application of in-depth analysis, interpretation, and discussion, often resulting in specific recommendations for action or for improving existing conditions. As Seawright and Gerring note, practical considerations such as time and access to information can influence case selection, but these issues should not be the sole factors used in describing the methodological justification for identifying a particular case to study. Given this, selecting a case includes considering the following:

• The case represents an unusual or atypical example of a research problem that requires more in-depth analysis? Cases often represent a topic that rests on the fringes of prior investigations because the case may provide new ways of understanding the research problem. For example, if the research problem is to identify strategies to improve policies that support girl's access to secondary education in predominantly Muslim nations, you could consider using Azerbaijan as a case study rather than selecting a more obvious nation in the Middle East. Doing so may reveal important new insights into recommending how governments in other predominantly Muslim nations can formulate policies that support improved access to education for girls.
• The case provides important insight or illuminate a previously hidden problem? In-depth analysis of a case can be based on the hypothesis that the case study will reveal trends or issues that have not been exposed in prior research or will reveal new and important implications for practice. For example, anecdotal evidence may suggest drug use among homeless veterans is related to their patterns of travel throughout the day. Assuming prior studies have not looked at individual travel choices as a way to study access to illicit drug use, a case study that observes a homeless veteran could reveal how issues of personal mobility choices facilitate regular access to illicit drugs. Note that it is important to conduct a thorough literature review to ensure that your assumption about the need to reveal new insights or previously hidden problems is valid and evidence-based.
• The case challenges and offers a counter-point to prevailing assumptions? Over time, research on any given topic can fall into a trap of developing assumptions based on outdated studies that are still applied to new or changing conditions or the idea that something should simply be accepted as "common sense," even though the issue has not been thoroughly tested in current practice. A case study analysis may offer an opportunity to gather evidence that challenges prevailing assumptions about a research problem and provide a new set of recommendations applied to practice that have not been tested previously. For example, perhaps there has been a long practice among scholars to apply a particular theory in explaining the relationship between two subjects of analysis. Your case could challenge this assumption by applying an innovative theoretical framework [perhaps borrowed from another discipline] to explore whether this approach offers new ways of understanding the research problem. Taking a contrarian stance is one of the most important ways that new knowledge and understanding develops from existing literature.
• The case provides an opportunity to pursue action leading to the resolution of a problem? Another way to think about choosing a case to study is to consider how the results from investigating a particular case may result in findings that reveal ways in which to resolve an existing or emerging problem. For example, studying the case of an unforeseen incident, such as a fatal accident at a railroad crossing, can reveal hidden issues that could be applied to preventative measures that contribute to reducing the chance of accidents in the future. In this example, a case study investigating the accident could lead to a better understanding of where to strategically locate additional signals at other railroad crossings so as to better warn drivers of an approaching train, particularly when visibility is hindered by heavy rain, fog, or at night.
• The case offers a new direction in future research? A case study can be used as a tool for an exploratory investigation that highlights the need for further research about the problem. A case can be used when there are few studies that help predict an outcome or that establish a clear understanding about how best to proceed in addressing a problem. For example, after conducting a thorough literature review [very important!], you discover that little research exists showing the ways in which women contribute to promoting water conservation in rural communities of east central Africa. A case study of how women contribute to saving water in a rural village of Uganda can lay the foundation for understanding the need for more thorough research that documents how women in their roles as cooks and family caregivers think about water as a valuable resource within their community. This example of a case study could also point to the need for scholars to build new theoretical frameworks around the topic [e.g., applying feminist theories of work and family to the issue of water conservation].

Eisenhardt, Kathleen M. “Building Theories from Case Study Research.” Academy of Management Review 14 (October 1989): 532-550; Emmel, Nick. Sampling and Choosing Cases in Qualitative Research: A Realist Approach . Thousand Oaks, CA: SAGE Publications, 2013; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Seawright, Jason and John Gerring. "Case Selection Techniques in Case Study Research." Political Research Quarterly 61 (June 2008): 294-308.

Structure and Writing Style

The purpose of a paper in the social sciences designed around a case study is to thoroughly investigate a subject of analysis in order to reveal a new understanding about the research problem and, in so doing, contributing new knowledge to what is already known from previous studies. In applied social sciences disciplines [e.g., education, social work, public administration, etc.], case studies may also be used to reveal best practices, highlight key programs, or investigate interesting aspects of professional work.

In general, the structure of a case study research paper is not all that different from a standard college-level research paper. However, there are subtle differences you should be aware of. Here are the key elements to organizing and writing a case study research paper.

I.  Introduction

As with any research paper, your introduction should serve as a roadmap for your readers to ascertain the scope and purpose of your study . The introduction to a case study research paper, however, should not only describe the research problem and its significance, but you should also succinctly describe why the case is being used and how it relates to addressing the problem. The two elements should be linked. With this in mind, a good introduction answers these four questions:

• What is being studied? Describe the research problem and describe the subject of analysis [the case] you have chosen to address the problem. Explain how they are linked and what elements of the case will help to expand knowledge and understanding about the problem.
• Why is this topic important to investigate? Describe the significance of the research problem and state why a case study design and the subject of analysis that the paper is designed around is appropriate in addressing the problem.
• What did we know about this topic before I did this study? Provide background that helps lead the reader into the more in-depth literature review to follow. If applicable, summarize prior case study research applied to the research problem and why it fails to adequately address the problem. Describe why your case will be useful. If no prior case studies have been used to address the research problem, explain why you have selected this subject of analysis.
• How will this study advance new knowledge or new ways of understanding? Explain why your case study will be suitable in helping to expand knowledge and understanding about the research problem.

Each of these questions should be addressed in no more than a few paragraphs. Exceptions to this can be when you are addressing a complex research problem or subject of analysis that requires more in-depth background information.

II.  Literature Review

The literature review for a case study research paper is generally structured the same as it is for any college-level research paper. The difference, however, is that the literature review is focused on providing background information and  enabling historical interpretation of the subject of analysis in relation to the research problem the case is intended to address . This includes synthesizing studies that help to:

• Place relevant works in the context of their contribution to understanding the case study being investigated . This would involve summarizing studies that have used a similar subject of analysis to investigate the research problem. If there is literature using the same or a very similar case to study, you need to explain why duplicating past research is important [e.g., conditions have changed; prior studies were conducted long ago, etc.].
• Describe the relationship each work has to the others under consideration that informs the reader why this case is applicable . Your literature review should include a description of any works that support using the case to investigate the research problem and the underlying research questions.
• Identify new ways to interpret prior research using the case study . If applicable, review any research that has examined the research problem using a different research design. Explain how your use of a case study design may reveal new knowledge or a new perspective or that can redirect research in an important new direction.
• Resolve conflicts amongst seemingly contradictory previous studies . This refers to synthesizing any literature that points to unresolved issues of concern about the research problem and describing how the subject of analysis that forms the case study can help resolve these existing contradictions.
• Point the way in fulfilling a need for additional research . Your review should examine any literature that lays a foundation for understanding why your case study design and the subject of analysis around which you have designed your study may reveal a new way of approaching the research problem or offer a perspective that points to the need for additional research.
• Expose any gaps that exist in the literature that the case study could help to fill . Summarize any literature that not only shows how your subject of analysis contributes to understanding the research problem, but how your case contributes to a new way of understanding the problem that prior research has failed to do.
• Locate your own research within the context of existing literature [very important!] . Collectively, your literature review should always place your case study within the larger domain of prior research about the problem. The overarching purpose of reviewing pertinent literature in a case study paper is to demonstrate that you have thoroughly identified and synthesized prior studies in relation to explaining the relevance of the case in addressing the research problem.

III.  Method

In this section, you explain why you selected a particular case [i.e., subject of analysis] and the strategy you used to identify and ultimately decide that your case was appropriate in addressing the research problem. The way you describe the methods used varies depending on the type of subject of analysis that constitutes your case study.

If your subject of analysis is an incident or event . In the social and behavioral sciences, the event or incident that represents the case to be studied is usually bounded by time and place, with a clear beginning and end and with an identifiable location or position relative to its surroundings. The subject of analysis can be a rare or critical event or it can focus on a typical or regular event. The purpose of studying a rare event is to illuminate new ways of thinking about the broader research problem or to test a hypothesis. Critical incident case studies must describe the method by which you identified the event and explain the process by which you determined the validity of this case to inform broader perspectives about the research problem or to reveal new findings. However, the event does not have to be a rare or uniquely significant to support new thinking about the research problem or to challenge an existing hypothesis. For example, Walo, Bull, and Breen conducted a case study to identify and evaluate the direct and indirect economic benefits and costs of a local sports event in the City of Lismore, New South Wales, Australia. The purpose of their study was to provide new insights from measuring the impact of a typical local sports event that prior studies could not measure well because they focused on large "mega-events." Whether the event is rare or not, the methods section should include an explanation of the following characteristics of the event: a) when did it take place; b) what were the underlying circumstances leading to the event; and, c) what were the consequences of the event in relation to the research problem.

If your subject of analysis is a person. Explain why you selected this particular individual to be studied and describe what experiences they have had that provide an opportunity to advance new understandings about the research problem. Mention any background about this person which might help the reader understand the significance of their experiences that make them worthy of study. This includes describing the relationships this person has had with other people, institutions, and/or events that support using them as the subject for a case study research paper. It is particularly important to differentiate the person as the subject of analysis from others and to succinctly explain how the person relates to examining the research problem [e.g., why is one politician in a particular local election used to show an increase in voter turnout from any other candidate running in the election]. Note that these issues apply to a specific group of people used as a case study unit of analysis [e.g., a classroom of students].

If your subject of analysis is a place. In general, a case study that investigates a place suggests a subject of analysis that is unique or special in some way and that this uniqueness can be used to build new understanding or knowledge about the research problem. A case study of a place must not only describe its various attributes relevant to the research problem [e.g., physical, social, historical, cultural, economic, political], but you must state the method by which you determined that this place will illuminate new understandings about the research problem. It is also important to articulate why a particular place as the case for study is being used if similar places also exist [i.e., if you are studying patterns of homeless encampments of veterans in open spaces, explain why you are studying Echo Park in Los Angeles rather than Griffith Park?]. If applicable, describe what type of human activity involving this place makes it a good choice to study [e.g., prior research suggests Echo Park has more homeless veterans].

If your subject of analysis is a phenomenon. A phenomenon refers to a fact, occurrence, or circumstance that can be studied or observed but with the cause or explanation to be in question. In this sense, a phenomenon that forms your subject of analysis can encompass anything that can be observed or presumed to exist but is not fully understood. In the social and behavioral sciences, the case usually focuses on human interaction within a complex physical, social, economic, cultural, or political system. For example, the phenomenon could be the observation that many vehicles used by ISIS fighters are small trucks with English language advertisements on them. The research problem could be that ISIS fighters are difficult to combat because they are highly mobile. The research questions could be how and by what means are these vehicles used by ISIS being supplied to the militants and how might supply lines to these vehicles be cut off? How might knowing the suppliers of these trucks reveal larger networks of collaborators and financial support? A case study of a phenomenon most often encompasses an in-depth analysis of a cause and effect that is grounded in an interactive relationship between people and their environment in some way.

NOTE:   The choice of the case or set of cases to study cannot appear random. Evidence that supports the method by which you identified and chose your subject of analysis should clearly support investigation of the research problem and linked to key findings from your literature review. Be sure to cite any studies that helped you determine that the case you chose was appropriate for examining the problem.

IV.  Discussion

The main elements of your discussion section are generally the same as any research paper, but centered around interpreting and drawing conclusions about the key findings from your analysis of the case study. Note that a general social sciences research paper may contain a separate section to report findings. However, in a paper designed around a case study, it is common to combine a description of the results with the discussion about their implications. The objectives of your discussion section should include the following:

Reiterate the Research Problem/State the Major Findings Briefly reiterate the research problem you are investigating and explain why the subject of analysis around which you designed the case study were used. You should then describe the findings revealed from your study of the case using direct, declarative, and succinct proclamation of the study results. Highlight any findings that were unexpected or especially profound.

Explain the Meaning of the Findings and Why They are Important Systematically explain the meaning of your case study findings and why you believe they are important. Begin this part of the section by repeating what you consider to be your most important or surprising finding first, then systematically review each finding. Be sure to thoroughly extrapolate what your analysis of the case can tell the reader about situations or conditions beyond the actual case that was studied while, at the same time, being careful not to misconstrue or conflate a finding that undermines the external validity of your conclusions.

Relate the Findings to Similar Studies No study in the social sciences is so novel or possesses such a restricted focus that it has absolutely no relation to previously published research. The discussion section should relate your case study results to those found in other studies, particularly if questions raised from prior studies served as the motivation for choosing your subject of analysis. This is important because comparing and contrasting the findings of other studies helps support the overall importance of your results and it highlights how and in what ways your case study design and the subject of analysis differs from prior research about the topic.

Consider Alternative Explanations of the Findings Remember that the purpose of social science research is to discover and not to prove. When writing the discussion section, you should carefully consider all possible explanations revealed by the case study results, rather than just those that fit your hypothesis or prior assumptions and biases. Be alert to what the in-depth analysis of the case may reveal about the research problem, including offering a contrarian perspective to what scholars have stated in prior research if that is how the findings can be interpreted from your case.

Acknowledge the Study's Limitations You can state the study's limitations in the conclusion section of your paper but describing the limitations of your subject of analysis in the discussion section provides an opportunity to identify the limitations and explain why they are not significant. This part of the discussion section should also note any unanswered questions or issues your case study could not address. More detailed information about how to document any limitations to your research can be found here .

Suggest Areas for Further Research Although your case study may offer important insights about the research problem, there are likely additional questions related to the problem that remain unanswered or findings that unexpectedly revealed themselves as a result of your in-depth analysis of the case. Be sure that the recommendations for further research are linked to the research problem and that you explain why your recommendations are valid in other contexts and based on the original assumptions of your study.

V.  Conclusion

As with any research paper, you should summarize your conclusion in clear, simple language; emphasize how the findings from your case study differs from or supports prior research and why. Do not simply reiterate the discussion section. Provide a synthesis of key findings presented in the paper to show how these converge to address the research problem. If you haven't already done so in the discussion section, be sure to document the limitations of your case study and any need for further research.

The function of your paper's conclusion is to: 1) reiterate the main argument supported by the findings from your case study; 2) state clearly the context, background, and necessity of pursuing the research problem using a case study design in relation to an issue, controversy, or a gap found from reviewing the literature; and, 3) provide a place to persuasively and succinctly restate the significance of your research problem, given that the reader has now been presented with in-depth information about the topic.

Consider the following points to help ensure your conclusion is appropriate:

• If the argument or purpose of your paper is complex, you may need to summarize these points for your reader.
• If prior to your conclusion, you have not yet explained the significance of your findings or if you are proceeding inductively, use the conclusion of your paper to describe your main points and explain their significance.
• Move from a detailed to a general level of consideration of the case study's findings that returns the topic to the context provided by the introduction or within a new context that emerges from your case study findings.

Note that, depending on the discipline you are writing in or the preferences of your professor, the concluding paragraph may contain your final reflections on the evidence presented as it applies to practice or on the essay's central research problem. However, the nature of being introspective about the subject of analysis you have investigated will depend on whether you are explicitly asked to express your observations in this way.

Problems to Avoid

Overgeneralization One of the goals of a case study is to lay a foundation for understanding broader trends and issues applied to similar circumstances. However, be careful when drawing conclusions from your case study. They must be evidence-based and grounded in the results of the study; otherwise, it is merely speculation. Looking at a prior example, it would be incorrect to state that a factor in improving girls access to education in Azerbaijan and the policy implications this may have for improving access in other Muslim nations is due to girls access to social media if there is no documentary evidence from your case study to indicate this. There may be anecdotal evidence that retention rates were better for girls who were engaged with social media, but this observation would only point to the need for further research and would not be a definitive finding if this was not a part of your original research agenda.

Failure to Document Limitations No case is going to reveal all that needs to be understood about a research problem. Therefore, just as you have to clearly state the limitations of a general research study , you must describe the specific limitations inherent in the subject of analysis. For example, the case of studying how women conceptualize the need for water conservation in a village in Uganda could have limited application in other cultural contexts or in areas where fresh water from rivers or lakes is plentiful and, therefore, conservation is understood more in terms of managing access rather than preserving access to a scarce resource.

Failure to Extrapolate All Possible Implications Just as you don't want to over-generalize from your case study findings, you also have to be thorough in the consideration of all possible outcomes or recommendations derived from your findings. If you do not, your reader may question the validity of your analysis, particularly if you failed to document an obvious outcome from your case study research. For example, in the case of studying the accident at the railroad crossing to evaluate where and what types of warning signals should be located, you failed to take into consideration speed limit signage as well as warning signals. When designing your case study, be sure you have thoroughly addressed all aspects of the problem and do not leave gaps in your analysis that leave the reader questioning the results.

Case Studies. Writing@CSU. Colorado State University; Gerring, John. Case Study Research: Principles and Practices . New York: Cambridge University Press, 2007; Merriam, Sharan B. Qualitative Research and Case Study Applications in Education . Rev. ed. San Francisco, CA: Jossey-Bass, 1998; Miller, Lisa L. “The Use of Case Studies in Law and Social Science Research.” Annual Review of Law and Social Science 14 (2018): TBD; Mills, Albert J., Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Putney, LeAnn Grogan. "Case Study." In Encyclopedia of Research Design , Neil J. Salkind, editor. (Thousand Oaks, CA: SAGE Publications, 2010), pp. 116-120; Simons, Helen. Case Study Research in Practice . London: SAGE Publications, 2009;  Kratochwill,  Thomas R. and Joel R. Levin, editors. Single-Case Research Design and Analysis: New Development for Psychology and Education .  Hilldsale, NJ: Lawrence Erlbaum Associates, 1992; Swanborn, Peter G. Case Study Research: What, Why and How? London : SAGE, 2010; Yin, Robert K. Case Study Research: Design and Methods . 6th edition. Los Angeles, CA, SAGE Publications, 2014; Walo, Maree, Adrian Bull, and Helen Breen. “Achieving Economic Benefits at Local Events: A Case Study of a Local Sports Event.” Festival Management and Event Tourism 4 (1996): 95-106.

Writing Tip

At Least Five Misconceptions about Case Study Research

Social science case studies are often perceived as limited in their ability to create new knowledge because they are not randomly selected and findings cannot be generalized to larger populations. Flyvbjerg examines five misunderstandings about case study research and systematically "corrects" each one. To quote, these are:

Misunderstanding 1 :  General, theoretical [context-independent] knowledge is more valuable than concrete, practical [context-dependent] knowledge. Misunderstanding 2 :  One cannot generalize on the basis of an individual case; therefore, the case study cannot contribute to scientific development. Misunderstanding 3 :  The case study is most useful for generating hypotheses; that is, in the first stage of a total research process, whereas other methods are more suitable for hypotheses testing and theory building. Misunderstanding 4 :  The case study contains a bias toward verification, that is, a tendency to confirm the researcher’s preconceived notions. Misunderstanding 5 :  It is often difficult to summarize and develop general propositions and theories on the basis of specific case studies [p. 221].

While writing your paper, think introspectively about how you addressed these misconceptions because to do so can help you strengthen the validity and reliability of your research by clarifying issues of case selection, the testing and challenging of existing assumptions, the interpretation of key findings, and the summation of case outcomes. Think of a case study research paper as a complete, in-depth narrative about the specific properties and key characteristics of your subject of analysis applied to the research problem.

Flyvbjerg, Bent. “Five Misunderstandings About Case-Study Research.” Qualitative Inquiry 12 (April 2006): 219-245.

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15.7 Evaluation: Presentation and Analysis of Case Study

Learning outcomes.

By the end of this section, you will be able to:

• Revise writing to follow the genre conventions of case studies.
• Evaluate the effectiveness and quality of a case study report.

Case studies follow a structure of background and context , methods , findings , and analysis . Body paragraphs should have main points and concrete details. In addition, case studies are written in formal language with precise wording and with a specific purpose and audience (generally other professionals in the field) in mind. Case studies also adhere to the conventions of the discipline’s formatting guide ( APA Documentation and Format in this study). Compare your case study with the following rubric as a final check.

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Home » Research Findings – Types Examples and Writing Guide

Research Findings – Types Examples and Writing Guide

Table of Contents

Research Findings

Definition:

Research findings refer to the results obtained from a study or investigation conducted through a systematic and scientific approach. These findings are the outcomes of the data analysis, interpretation, and evaluation carried out during the research process.

Types of Research Findings

There are two main types of research findings:

Qualitative Findings

Qualitative research is an exploratory research method used to understand the complexities of human behavior and experiences. Qualitative findings are non-numerical and descriptive data that describe the meaning and interpretation of the data collected. Examples of qualitative findings include quotes from participants, themes that emerge from the data, and descriptions of experiences and phenomena.

Quantitative Findings

Quantitative research is a research method that uses numerical data and statistical analysis to measure and quantify a phenomenon or behavior. Quantitative findings include numerical data such as mean, median, and mode, as well as statistical analyses such as t-tests, ANOVA, and regression analysis. These findings are often presented in tables, graphs, or charts.

Both qualitative and quantitative findings are important in research and can provide different insights into a research question or problem. Combining both types of findings can provide a more comprehensive understanding of a phenomenon and improve the validity and reliability of research results.

Parts of Research Findings

Research findings typically consist of several parts, including:

• Introduction: This section provides an overview of the research topic and the purpose of the study.
• Literature Review: This section summarizes previous research studies and findings that are relevant to the current study.
• Methodology : This section describes the research design, methods, and procedures used in the study, including details on the sample, data collection, and data analysis.
• Results : This section presents the findings of the study, including statistical analyses and data visualizations.
• Discussion : This section interprets the results and explains what they mean in relation to the research question(s) and hypotheses. It may also compare and contrast the current findings with previous research studies and explore any implications or limitations of the study.
• Conclusion : This section provides a summary of the key findings and the main conclusions of the study.
• Recommendations: This section suggests areas for further research and potential applications or implications of the study’s findings.

How to Write Research Findings

Writing research findings requires careful planning and attention to detail. Here are some general steps to follow when writing research findings:

• Organize your findings: Before you begin writing, it’s essential to organize your findings logically. Consider creating an outline or a flowchart that outlines the main points you want to make and how they relate to one another.
• Use clear and concise language : When presenting your findings, be sure to use clear and concise language that is easy to understand. Avoid using jargon or technical terms unless they are necessary to convey your meaning.
• Use visual aids : Visual aids such as tables, charts, and graphs can be helpful in presenting your findings. Be sure to label and title your visual aids clearly, and make sure they are easy to read.
• Use headings and subheadings: Using headings and subheadings can help organize your findings and make them easier to read. Make sure your headings and subheadings are clear and descriptive.
• Interpret your findings : When presenting your findings, it’s important to provide some interpretation of what the results mean. This can include discussing how your findings relate to the existing literature, identifying any limitations of your study, and suggesting areas for future research.
• Be precise and accurate : When presenting your findings, be sure to use precise and accurate language. Avoid making generalizations or overstatements and be careful not to misrepresent your data.
• Edit and revise: Once you have written your research findings, be sure to edit and revise them carefully. Check for grammar and spelling errors, make sure your formatting is consistent, and ensure that your writing is clear and concise.

Research Findings Example

Following is a Research Findings Example sample for students:

Title: The Effects of Exercise on Mental Health

Sample : 500 participants, both men and women, between the ages of 18-45.

Methodology : Participants were divided into two groups. The first group engaged in 30 minutes of moderate intensity exercise five times a week for eight weeks. The second group did not exercise during the study period. Participants in both groups completed a questionnaire that assessed their mental health before and after the study period.

Findings : The group that engaged in regular exercise reported a significant improvement in mental health compared to the control group. Specifically, they reported lower levels of anxiety and depression, improved mood, and increased self-esteem.

Conclusion : Regular exercise can have a positive impact on mental health and may be an effective intervention for individuals experiencing symptoms of anxiety or depression.

Applications of Research Findings

Research findings can be applied in various fields to improve processes, products, services, and outcomes. Here are some examples:

• Healthcare : Research findings in medicine and healthcare can be applied to improve patient outcomes, reduce morbidity and mortality rates, and develop new treatments for various diseases.
• Education : Research findings in education can be used to develop effective teaching methods, improve learning outcomes, and design new educational programs.
• Technology : Research findings in technology can be applied to develop new products, improve existing products, and enhance user experiences.
• Business : Research findings in business can be applied to develop new strategies, improve operations, and increase profitability.
• Public Policy: Research findings can be used to inform public policy decisions on issues such as environmental protection, social welfare, and economic development.
• Social Sciences: Research findings in social sciences can be used to improve understanding of human behavior and social phenomena, inform public policy decisions, and develop interventions to address social issues.
• Agriculture: Research findings in agriculture can be applied to improve crop yields, develop new farming techniques, and enhance food security.
• Sports : Research findings in sports can be applied to improve athlete performance, reduce injuries, and develop new training programs.

When to use Research Findings

Research findings can be used in a variety of situations, depending on the context and the purpose. Here are some examples of when research findings may be useful:

• Decision-making : Research findings can be used to inform decisions in various fields, such as business, education, healthcare, and public policy. For example, a business may use market research findings to make decisions about new product development or marketing strategies.
• Problem-solving : Research findings can be used to solve problems or challenges in various fields, such as healthcare, engineering, and social sciences. For example, medical researchers may use findings from clinical trials to develop new treatments for diseases.
• Policy development : Research findings can be used to inform the development of policies in various fields, such as environmental protection, social welfare, and economic development. For example, policymakers may use research findings to develop policies aimed at reducing greenhouse gas emissions.
• Program evaluation: Research findings can be used to evaluate the effectiveness of programs or interventions in various fields, such as education, healthcare, and social services. For example, educational researchers may use findings from evaluations of educational programs to improve teaching and learning outcomes.
• Innovation: Research findings can be used to inspire or guide innovation in various fields, such as technology and engineering. For example, engineers may use research findings on materials science to develop new and innovative products.

Purpose of Research Findings

The purpose of research findings is to contribute to the knowledge and understanding of a particular topic or issue. Research findings are the result of a systematic and rigorous investigation of a research question or hypothesis, using appropriate research methods and techniques.

The main purposes of research findings are:

• To generate new knowledge : Research findings contribute to the body of knowledge on a particular topic, by adding new information, insights, and understanding to the existing knowledge base.
• To test hypotheses or theories : Research findings can be used to test hypotheses or theories that have been proposed in a particular field or discipline. This helps to determine the validity and reliability of the hypotheses or theories, and to refine or develop new ones.
• To inform practice: Research findings can be used to inform practice in various fields, such as healthcare, education, and business. By identifying best practices and evidence-based interventions, research findings can help practitioners to make informed decisions and improve outcomes.
• To identify gaps in knowledge: Research findings can help to identify gaps in knowledge and understanding of a particular topic, which can then be addressed by further research.
• To contribute to policy development: Research findings can be used to inform policy development in various fields, such as environmental protection, social welfare, and economic development. By providing evidence-based recommendations, research findings can help policymakers to develop effective policies that address societal challenges.

Characteristics of Research Findings

Research findings have several key characteristics that distinguish them from other types of information or knowledge. Here are some of the main characteristics of research findings:

• Objective : Research findings are based on a systematic and rigorous investigation of a research question or hypothesis, using appropriate research methods and techniques. As such, they are generally considered to be more objective and reliable than other types of information.
• Empirical : Research findings are based on empirical evidence, which means that they are derived from observations or measurements of the real world. This gives them a high degree of credibility and validity.
• Generalizable : Research findings are often intended to be generalizable to a larger population or context beyond the specific study. This means that the findings can be applied to other situations or populations with similar characteristics.
• Transparent : Research findings are typically reported in a transparent manner, with a clear description of the research methods and data analysis techniques used. This allows others to assess the credibility and reliability of the findings.
• Peer-reviewed: Research findings are often subject to a rigorous peer-review process, in which experts in the field review the research methods, data analysis, and conclusions of the study. This helps to ensure the validity and reliability of the findings.
• Reproducible : Research findings are often designed to be reproducible, meaning that other researchers can replicate the study using the same methods and obtain similar results. This helps to ensure the validity and reliability of the findings.

Advantages of Research Findings

Research findings have many advantages, which make them valuable sources of knowledge and information. Here are some of the main advantages of research findings:

• Evidence-based: Research findings are based on empirical evidence, which means that they are grounded in data and observations from the real world. This makes them a reliable and credible source of information.
• Inform decision-making: Research findings can be used to inform decision-making in various fields, such as healthcare, education, and business. By identifying best practices and evidence-based interventions, research findings can help practitioners and policymakers to make informed decisions and improve outcomes.
• Identify gaps in knowledge: Research findings can help to identify gaps in knowledge and understanding of a particular topic, which can then be addressed by further research. This contributes to the ongoing development of knowledge in various fields.
• Improve outcomes : Research findings can be used to develop and implement evidence-based practices and interventions, which have been shown to improve outcomes in various fields, such as healthcare, education, and social services.
• Foster innovation: Research findings can inspire or guide innovation in various fields, such as technology and engineering. By providing new information and understanding of a particular topic, research findings can stimulate new ideas and approaches to problem-solving.
• Enhance credibility: Research findings are generally considered to be more credible and reliable than other types of information, as they are based on rigorous research methods and are subject to peer-review processes.

Limitations of Research Findings

While research findings have many advantages, they also have some limitations. Here are some of the main limitations of research findings:

• Limited scope: Research findings are typically based on a particular study or set of studies, which may have a limited scope or focus. This means that they may not be applicable to other contexts or populations.
• Potential for bias : Research findings can be influenced by various sources of bias, such as researcher bias, selection bias, or measurement bias. This can affect the validity and reliability of the findings.
• Ethical considerations: Research findings can raise ethical considerations, particularly in studies involving human subjects. Researchers must ensure that their studies are conducted in an ethical and responsible manner, with appropriate measures to protect the welfare and privacy of participants.
• Time and resource constraints : Research studies can be time-consuming and require significant resources, which can limit the number and scope of studies that are conducted. This can lead to gaps in knowledge or a lack of research on certain topics.
• Complexity: Some research findings can be complex and difficult to interpret, particularly in fields such as science or medicine. This can make it challenging for practitioners and policymakers to apply the findings to their work.
• Lack of generalizability : While research findings are intended to be generalizable to larger populations or contexts, there may be factors that limit their generalizability. For example, cultural or environmental factors may influence how a particular intervention or treatment works in different populations or contexts.

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Muhammad Hassan

Researcher, Academic Writer, Web developer

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How to present patient cases

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• Mary Ni Lochlainn , foundation year 2 doctor 1 ,
• Ibrahim Balogun , healthcare of older people/stroke medicine consultant 1
• 1 East Kent Foundation Trust, UK

A guide on how to structure a case presentation

This article contains...

-History of presenting problem

-Medical and surgical history

-Drugs, including allergies to drugs

-Family history

-Social history

-Review of systems

-Findings on examination, including vital signs and observations

-Differential diagnosis/impression

-Investigations

-Management

Presenting patient cases is a key part of everyday clinical practice. A well delivered presentation has the potential to facilitate patient care and improve efficiency on ward rounds, as well as a means of teaching and assessing clinical competence. 1

The purpose of a case presentation is to communicate your diagnostic reasoning to the listener, so that he or she has a clear picture of the patient’s condition and further management can be planned accordingly. 2 To give a high quality presentation you need to take a thorough history. Consultants make decisions about patient care based on information presented to them by junior members of the team, so the importance of accurately presenting your patient cannot be overemphasised.

As a medical student, you are likely to be asked to present in numerous settings. A formal case presentation may take place at a teaching session or even at a conference or scientific meeting. These presentations are usually thorough and have an accompanying PowerPoint presentation or poster. More often, case presentations take place on the wards or over the phone and tend to be brief, using only memory or short, handwritten notes as an aid.

Everyone has their own presenting style, and the context of the presentation will determine how much detail you need to put in. You should anticipate what information your senior colleagues will need to know about the patient’s history and the care he or she has received since admission, to enable them to make further management decisions. In this article, I use a fictitious case to show how you can structure case presentations, which can be adapted to different clinical and teaching settings (box 1).

Box 1: Structure for presenting patient cases

Presenting problem, history of presenting problem, medical and surgical history.

Drugs, including allergies to drugs

Family history

Social history, review of systems.

Findings on examination, including vital signs and observations

Differential diagnosis/impression

Investigations

Case: tom murphy.

You should start with a sentence that includes the patient’s name, sex (Mr/Ms), age, and presenting symptoms. In your presentation, you may want to include the patient’s main diagnosis if known—for example, “admitted with shortness of breath on a background of COPD [chronic obstructive pulmonary disease].” You should include any additional information that might give the presentation of symptoms further context, such as the patient’s profession, ethnic origin, recent travel, or chronic conditions.

“ Mr Tom Murphy is a 56 year old ex-smoker admitted with sudden onset central crushing chest pain that radiated down his left arm.”

In this section you should expand on the presenting problem. Use the SOCRATES mnemonic to help describe the pain (see box 2). If the patient has multiple problems, describe each in turn, covering one system at a time.

Box 2: SOCRATES—mnemonic for pain

Associations

Time course

Exacerbating/relieving factors

“ The pain started suddenly at 1 pm, when Mr Murphy was at his desk. The pain was dull in nature, and radiated down his left arm. He experienced shortness of breath and felt sweaty and clammy. His colleague phoned an ambulance. He rated the pain 9/10 in severity. In the ambulance he was given GTN [glyceryl trinitrate] spray under the tongue, which relieved the pain to 5/10. The pain lasted 30 minutes in total. No exacerbating factors were noted. Of note: Mr Murphy is an ex-smoker with a 20 pack year history”

Some patients have multiple comorbidities, and the most life threatening conditions should be mentioned first. They can also be categorised by organ system—for example, “has a long history of cardiovascular disease, having had a stroke, two TIAs [transient ischaemic attacks], and previous ACS [acute coronary syndrome].” For some conditions it can be worth stating whether a general practitioner or a specialist manages it, as this gives an indication of its severity.

In a surgical case, colleagues will be interested in exercise tolerance and any comorbidity that could affect the patient’s fitness for surgery and anaesthesia. If the patient has had any previous surgical procedures, mention whether there were any complications or reactions to anaesthesia.

“Mr Murphy has a history of type 2 diabetes, well controlled on metformin. He also has hypertension, managed with ramipril, and gout. Of note: he has no history of ischaemic heart disease (relevant negative) (see box 3).”

Box 3: Relevant negatives

Mention any relevant negatives that will help narrow down the differential diagnosis or could be important in the management of the patient, 3 such as any risk factors you know for the condition and any associations that you are aware of. For example, if the differential diagnosis includes a condition that you know can be hereditary, a relevant negative could be the lack of a family history. If the differential diagnosis includes cardiovascular disease, mention the cardiovascular risk factors such as body mass index, smoking, and high cholesterol.

Highlight any recent changes to the patient’s drugs because these could be a factor in the presenting problem. Mention any allergies to drugs or the patient’s non-compliance to a previously prescribed drug regimen.

To link the medical history and the drugs you might comment on them together, either here or in the medical history. “Mrs Walsh’s drugs include regular azathioprine for her rheumatoid arthritis.”Or, “His regular drugs are ramipril 5 mg once a day, metformin 1g three times a day, and allopurinol 200 mg once a day. He has no known drug allergies.”

If the family history is unrelated to the presenting problem, it is sufficient to say “no relevant family history noted.” For hereditary conditions more detail is needed.

“ Mr Murphy’s father experienced a fatal myocardial infarction aged 50.”

Social history should include the patient’s occupation; their smoking, alcohol, and illicit drug status; who they live with; their relationship status; and their sexual history, baseline mobility, and travel history. In an older patient, more detail is usually required, including whether or not they have carers, how often the carers help, and if they need to use walking aids.

“He works as an accountant and is an ex-smoker since five years ago with a 20 pack year history. He drinks about 14 units of alcohol a week. He denies any illicit drug use. He lives with his wife in a two storey house and is independent in all activities of daily living.”

Do not dwell on this section. If something comes up that is relevant to the presenting problem, it should be mentioned in the history of the presenting problem rather than here.

“Systems review showed long standing occasional lower back pain, responsive to paracetamol.”

Findings on examination

Initially, it can be useful to practise presenting the full examination to make sure you don’t leave anything out, but it is rare that you would need to present all the normal findings. Instead, focus on the most important main findings and any abnormalities.

“On examination the patient was comfortable at rest, heart sounds one and two were heard with no additional murmurs, heaves, or thrills. Jugular venous pressure was not raised. No peripheral oedema was noted and calves were soft and non-tender. Chest was clear on auscultation. Abdomen was soft and non-tender and normal bowel sounds were heard. GCS [Glasgow coma scale] was 15, pupils were equal and reactive to light [PEARL], cranial nerves 1-12 were intact, and he was moving all four limbs. Observations showed an early warning score of 1 for a tachycardia of 105 beats/ min. Blood pressure was 150/90 mm Hg, respiratory rate 18 breaths/min, saturations were 98% on room air, and he was apyrexial with a temperature of 36.8 ºC.”

Differential diagnoses

Mentioning one or two of the most likely diagnoses is sufficient. A useful phrase you can use is, “I would like to rule out,” especially when you suspect a more serious cause is in the differential diagnosis. “History and examination were in keeping with diverticular disease; however, I would like to rule out colorectal cancer in this patient.”

Remember common things are common, so try not to mention rare conditions first. Sometimes it is acceptable to report investigations you would do first, and then base your differential diagnosis on what the history and investigation findings tell you.

“My impression is acute coronary syndrome. The differential diagnosis includes other cardiovascular causes such as acute pericarditis, myocarditis, aortic stenosis, aortic dissection, and pulmonary embolism. Possible respiratory causes include pneumonia or pneumothorax. Gastrointestinal causes include oesophageal spasm, oesophagitis, gastro-oesophageal reflux disease, gastritis, cholecystitis, and acute pancreatitis. I would also consider a musculoskeletal cause for the pain.”

This section can include a summary of the investigations already performed and further investigations that you would like to request. “On the basis of these differentials, I would like to carry out the following investigations: 12 lead electrocardiography and blood tests, including full blood count, urea and electrolytes, clotting screen, troponin levels, lipid profile, and glycated haemoglobin levels. I would also book a chest radiograph and check the patient’s point of care blood glucose level.”

You should consider recommending investigations in a structured way, prioritising them by how long they take to perform and how easy it is to get them done and how long it takes for the results to come back. Put the quickest and easiest first: so bedside tests, electrocardiography, followed by blood tests, plain radiology, then special tests. You should always be able to explain why you would like to request a test. Mention the patient’s baseline test values if they are available, especially if the patient has a chronic condition—for example, give the patient’s creatinine levels if he or she has chronic kidney disease This shows the change over time and indicates the severity of the patient’s current condition.

“To further investigate these differentials, 12 lead electrocardiography was carried out, which showed ST segment depression in the anterior leads. Results of laboratory tests showed an initial troponin level of 85 µg/L, which increased to 1250 µg/L when repeated at six hours. Blood test results showed raised total cholesterol at 7.6 mmol /L and nil else. A chest radiograph showed clear lung fields. Blood glucose level was 6.3 mmol/L; a glycated haemoglobin test result is pending.”

Dependent on the case, you may need to describe the management plan so far or what further management you would recommend.“My management plan for this patient includes ACS [acute coronary syndrome] protocol, echocardiography, cardiology review, and treatment with high dose statins. If you are unsure what the management should be, you should say that you would discuss further with senior colleagues and the patient. At this point, check to see if there is a treatment escalation plan or a “do not attempt to resuscitate” order in place.

“Mr Murphy was given ACS protocol in the emergency department. An echocardiogram has been requested and he has been discussed with cardiology, who are going to come and see him. He has also been started on atorvastatin 80 mg nightly. Mr Murphy and his family are happy with this plan.”

The summary can be a concise recap of what you have presented beforehand or it can sometimes form a standalone presentation. Pick out salient points, such as positive findings—but also draw conclusions from what you highlight. Finish with a brief synopsis of the current situation (“currently pain free”) and next step (“awaiting cardiology review”). Do not trail off at the end, and state the diagnosis if you are confident you know what it is. If you are not sure what the diagnosis is then communicate this uncertainty and do not pretend to be more confident than you are. When possible, you should include the patient’s thoughts about the diagnosis, how they are feeling generally, and if they are happy with the management plan.

“In summary, Mr Murphy is a 56 year old man admitted with central crushing chest pain, radiating down his left arm, of 30 minutes’ duration. His cardiac risk factors include 20 pack year smoking history, positive family history, type 2 diabetes, and hypertension. Examination was normal other than tachycardia. However, 12 lead electrocardiography showed ST segment depression in the anterior leads and troponin rise from 85 to 250 µg/L. Acute coronary syndrome protocol was initiated and a diagnosis of NSTEMI [non-ST elevation myocardial infarction] was made. Mr Murphy is currently pain free and awaiting cardiology review.”

Originally published as: Student BMJ 2017;25:i4406

Competing interests: None declared.

Provenance and peer review: Not commissioned; externally peer reviewed

• ↵ Green EH, Durning SJ, DeCherrie L, Fagan MJ, Sharpe B, Hershman W. Expectations for oral case presentations for clinical clerks: opinions of internal medicine clerkship directors. J Gen Intern Med 2009 ; 24 : 370 - 3 . doi:10.1007/s11606-008-0900-x   pmid:19139965 . OpenUrl CrossRef PubMed Web of Science
• ↵ Olaitan A, Okunade O, Corne J. How to present clinical cases. Student BMJ 2010;18:c1539.
• ↵ Gaillard F. The secret art of relevant negatives, Radiopedia 2016; http://radiopaedia.org/blog/the-secret-art-of-relevant-negatives .

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Case study: 60-year-old female presenting with shortness of breath.

Deepa Rawat ; Sandeep Sharma .

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Last Update: February 20, 2023 .

• Case Presentation

The patient is a 60-year-old white female presenting to the emergency department with acute onset shortness of breath.  Symptoms began approximately 2 days before and had progressively worsened with no associated, aggravating, or relieving factors noted. She had similar symptoms approximately 1 year ago with an acute, chronic obstructive pulmonary disease (COPD) exacerbation requiring hospitalization. She uses BiPAP ventilatory support at night when sleeping and has requested to use this in the emergency department due to shortness of breath and wanting to sleep.

She denies fever, chills, cough, wheezing, sputum production, chest pain, palpitations, pressure, abdominal pain, abdominal distension, nausea, vomiting, and diarrhea.

She reports difficulty breathing at rest, forgetfulness, mild fatigue, feeling chilled, requiring blankets, increased urinary frequency, incontinence, and swelling in her bilateral lower extremities that are new-onset and worsening. Subsequently, she has not ambulated from bed for several days except to use the restroom due to feeling weak, fatigued, and short of breath.

There are no known ill contacts at home. Her family history includes significant heart disease and prostate malignancy in her father. Social history is positive for smoking tobacco use at 30 pack years. She quit smoking 2 years ago due to increasing shortness of breath. She denies all alcohol and illegal drug use. There are no known foods, drugs, or environmental allergies.

Past medical history is significant for coronary artery disease, myocardial infarction, COPD, hypertension, hyperlipidemia, hypothyroidism, diabetes mellitus, peripheral vascular disease, tobacco usage, and obesity.  Past surgical history is significant for an appendectomy, cardiac catheterization with stent placement, hysterectomy, and nephrectomy.

Her current medications include fluticasone-vilanterol 100-25 mcg inhaled daily, hydralazine 50 mg by mouth, 3 times per day, hydrochlorothiazide 25 mg by mouth daily, albuterol-ipratropium inhaled every 4 hours PRN, levothyroxine 175 mcg by mouth daily, metformin 500 mg by mouth twice per day, nebivolol 5 mg by mouth daily, aspirin 81 mg by mouth daily, vitamin D3 1000 units by mouth daily, clopidogrel 75 mg by mouth daily, isosorbide mononitrate 60 mg by mouth daily, and rosuvastatin 40 mg by mouth daily.

Physical Exam

Initial physical exam reveals temperature 97.3 F, heart rate 74 bpm, respiratory rate 24, BP 104/54, HT 160 cm, WT 100 kg, BMI 39.1, and O2 saturation 90% on room air.

Constitutional:  Extremely obese, acutely ill-appearing female. Well-developed and well-nourished with BiPAP in place. Lying on a hospital stretcher under 3 blankets.

HEENT: 

• Head: Normocephalic and atraumatic
• Mouth: Moist mucous membranes 
• Macroglossia
• Eyes: Conjunctiva and EOM are normal. Pupils are equal, round, and reactive to light. No scleral icterus. Bilateral periorbital edema present.
• Neck: Neck supple. No JVD present. No masses or surgical scarring. 
• Throat: Patent and moist

Cardiovascular:  Normal rate, regular rhythm, and normal heart sound with no murmur. 2+ pitting edema bilateral lower extremities and strong pulses in all four extremities.

Pulmonary/Chest:  No respiratory status distress at this time, tachypnea present, (+) wheezing noted, bilateral rhonchi, decreased air movement bilaterally. The patient was barely able to finish a full sentence due to shortness of breath.

Abdominal:  Soft. Obese. Bowel sounds are normal. No distension and no tenderness

Skin: Skin is very dry

Neurologic: Alert, awake, able to protect her airway. Moving all extremities. No sensation losses

• Initial Evaluation

Initial evaluation to elucidate the source of dyspnea was performed and included CBC to establish if an infectious or anemic source was present, CMP to review electrolyte balance and review renal function, and arterial blood gas to determine the PO2 for hypoxia and any major acid-base derangement, creatinine kinase and troponin I to evaluate the presence of myocardial infarct or rhabdomyolysis, brain natriuretic peptide, ECG, and chest x-ray. Considering that it is winter and influenza is endemic in the community, a rapid influenza assay was obtained as well.

Largely unremarkable and non-contributory to establish a diagnosis.

Showed creatinine elevation above baseline from 1.08 base to 1.81, indicating possible acute injury. EGFR at 28 is consistent with chronic renal disease. Calcium was elevated to 10.2. However, when corrected for albumin, this corrected to 9.8 mg/dL. Mild transaminitis is present as seen in alkaline phosphatase, AST, and ALT measurements which could be due to liver congestion from volume overload.

Initial arterial blood gas with pH 7.491, PCO2 27.6, PO2 53.6, HCO3 20.6, and oxygen saturation 90% on room air, indicating respiratory alkalosis with hypoxic respiratory features.

Creatinine kinase was elevated along with serial elevated troponin I studies. In the setting of her known chronic renal failure and acute injury indicated by the above creatinine value, a differential of rhabdomyolysis is determined.

Influenza A and B: Negative

Normal sinus rhythm with non-specific ST changes in inferior leads. Decreased voltage in leads I, III, aVR, aVL, aVF.

Chest X-ray

Findings: Bibasilar airspace disease that may represent alveolar edema. Cardiomegaly noted. Prominent interstitial markings were noted. Small bilateral pleural effusions

Radiologist Impression: Radiographic changes of congestive failure with bilateral pleural effusions greater on the left compared to the right

• Differential Diagnosis
• Acute on chronic COPD exacerbation
• Acute on chronic renal failure
• Bacterial pneumonia
• Congestive heart failure
• Pericardial effusion
• Hypothyroidism
• Influenza pneumonia
• Pulmonary edema
• Pulmonary embolism
• Confirmatory Evaluation

On the second day of the admission patient’s shortness of breath was not improved, and she was more confused with difficulty arousing on conversation and examination. To further elucidate the etiology of her shortness of breath and confusion, the patient's husband provided further history. He revealed that she is poorly compliant with taking her medications. He reports that she “doesn’t see the need to take so many pills.”

Testing was performed to include TSH, free T4, BNP, repeated arterial blood gas, CT scan of the chest, and echocardiogram. TSH and free T4 evaluate hypothyroidism. BNP evaluates fluid load status and possible congestive heart failure. CT scan of the chest will look for anatomical abnormalities. An echocardiogram is used to evaluate left ventricular ejection fraction, right ventricular function, pulmonary artery pressure, valvular function, pericardial effusion, and any hypokinetic area.

• TSH: 112.717 (H)
• Free T4: 0.56 (L)
• TSH and Free T4 values indicate severe primary hypothyroidism. 

BNP can be falsely low in obese patients due to the increased surface area. Additionally, adipose tissue has BNP receptors which augment the true BNP value. Also, African American patients with more excretion may have falsely low values secondary to greater excretion of BNP. This test is not that helpful in renal failure due to the chronic nature of fluid overload. This allows for desensitization of the cardiac tissues with a subsequent decrease in BNP release.

Repeat arterial blood gas on BiPAP ventilation shows pH 7.397, PCO2 35.3, PO2 72.4, HCO3 21.2, and oxygen saturation 90% on 2 L supplemental oxygen.

CT chest without contrast was primarily obtained to evaluate the left hemithorax, especially the retrocardiac area.

Radiologist Impression: Tiny bilateral pleural effusions. Pericardial effusion. Coronary artery calcification. Some left lung base atelectasis with minimal airspace disease.

Echocardiogram

The left ventricular systolic function is normal. The left ventricular cavity is borderline dilated.

The pericardial fluid is collected primarily posteriorly, laterally but not apically. There appeared to be a subtle, early hemodynamic effect of the pericardial fluid on the right-sided chambers by way of an early diastolic collapse of the RA/RV and delayed RV expansion until late diastole. A dedicated tamponade study was not performed. 

The estimated ejection fraction appears to be in the range of 66% to 70%. The left ventricular cavity is borderline dilated.

The aortic valve is abnormal in structure and exhibits sclerosis.

The mitral valve is abnormal in structure. Mild mitral annular calcification is present. There is bilateral thickening present. Trace mitral valve regurgitation is present.

• Myxedema coma or severe hypothyroidism
• Pericardial effusion secondary to myxedema coma
• COPD exacerbation
• Acute on chronic hypoxic respiratory failure
• Acute respiratory alkalosis
• Bilateral community-acquired pneumonia
• Small bilateral pleural effusions
• Acute mild rhabdomyolysis
• Acute chronic, stage IV, renal failure
• Elevated troponin I levels, likely secondary to Renal failure 
• Diabetes mellitus type 2, non-insulin-dependent
• Extreme obesity
• Hepatic dysfunction

The patient was extremely ill and rapidly decompensating with multisystem organ failure, including respiratory failure, altered mental status, acute on chronic renal failure, and cardiac dysfunction. The primary concerns for the stability of the patient revolved around respiratory failure coupled with altered mental status. In the intensive care unit (ICU), she rapidly began to fail BiPAP therapy. Subsequently, the patient was emergently intubated in the ICU.  A systemic review of therapies and hospital course is as follows:

Considering the primary diagnosis of myxedema coma, early supplementation with thyroid hormone is essential. Healthcare providers followed the American Thyroid Association recommendations, which recommend giving combined T3 and T4 supplementation; however, T4 alone may also be used. T3 therapy is given as a bolus of 5 to 20 micrograms intravenously and continued at 2.5 to 10 micrograms every 8 hours. An intravenous loading dose of 300 to 600 micrograms of T4 is followed by a daily intravenous dose of 50 to 100 micrograms. Repeated monitoring of TSH and T4 should be performed every 1 to 2 days to evaluate the effect and to titrate the dose of medication. The goal is to improve mental function. Until coexistent adrenal insufficiency is ruled out using a random serum cortisol measurement, 50 to 100 mg every 8 hours of hydrocortisone should be administered. In this case, clinicians used hydrocortisone 100 mg IV every 8 hours. Dexamethasone 2 to 4 mg every 12 hours is an alternative therapy.

The patient’s mental status rapidly worsened despite therapy. In the setting of her hypothyroidism history, this may be myxedema coma or due to the involvement of another organ system. The thyroid supplementation medications and hydrocortisone were continued. A CT head without contrast was normal.

Respiratory

For worsening metabolic acidosis and airway protection, the patient was emergently intubated. Her airway was deemed high risk due to having a large tongue, short neck, and extreme obesity. As the patient’s heart was preload dependent secondary to pericardial effusion, a 1-liter normal saline bolus was started. Norepinephrine was started at a low dose for vasopressor support, and ketamine with low dose Propofol was used for sedation. Ketamine is a sympathomimetic medication and usually does not cause hypotension as all other sedatives do. The patient was ventilated with AC mode of ventilation, tidal volume of 6 ml/kg ideal body weight, flow 70, initial fio2 100 %, rate 26 per minute (to compensate for metabolic acidosis), PEEP of 8.

Cardiovascular

She was determined to be hemodynamically stable with a pericardial effusion. This patient’s cardiac dysfunction was diastolic in nature, as suggested by an ejection fraction of 66% to 70%. The finding of posterior pericardial effusion further supported this conclusion. The posterior nature of this effusion was not amenable to pericardiocentesis. As such, this patient was preload dependent and showed signs of hypotension. The need for crystalloid fluid resuscitation was balanced against the impact increased intravascular volume would have on congestive heart failure and fluid overload status. Thyroid hormone replacement as above should improve hypotension. However, vasopressor agents may be used to maintain vital organ perfusion targeting a mean arterial pressure of greater than 65 mm Hg as needed. BP improved after fluid bolus, and eventually, the norepinephrine was stopped. Serial echocardiograms were obtained to ensure that the patient did not develop tamponade physiology. Total CK was elevated, which was likely due to Hypothyroidism compounded with chronic renal disease.

Infectious Disease

Blood cultures, urine analysis, and sputum cultures were obtained. The patient's white blood cell count was normal. This is likely secondary to her being immunocompromised due to hypothyroidism and diabetes. In part, the pulmonary findings of diffuse edema and bilateral pleural effusions can be explained by cardiac dysfunction. Thoracentesis of pleural fluid was attempted, and the fluid was analyzed for cytology and gram staining to rule out infectious or malignant causes as both a therapeutic and diagnostic measure. Until these results return, broad-spectrum antibiotics are indicated and may be discontinued once the infection is ruled out completely.

Gastrointestinal

Nasogastric tube feedings were started on the patient after intubation. She tolerated feedings well. AST and ALT were mildly elevated, which was thought to be due to hypothyroidism, and as the TSH and free T4 improved, her AST and ALT improved. Eventually, these values became normal once her TSH level was close to 50.

Her baseline creatinine was found to be close to 1.08 in prior medical records. She presented with a creatinine of 1.8 in the emergency department. Since hypothyroidism causes fluid retention in part because thyroid hormone encourages excretion of free water and partly due to decreased lymphatic function in returning fluid to vascular circulation.  Aggressive diuresis was attempted. As a result, her creatinine increased initially but improved on repeated evaluation, and the patient had a new baseline creatinine of 1.6. Overall she had a net change in the fluid status of 10 liters negative by her ten days of admission in the ICU.

Mildly anemic otherwise, WBC and platelet counts were normal. Electrolyte balance should be monitored closely, paying attention to sodium, potassium, chloride, and calcium specifically as these are worsened in both renal failure and myxedema. 

Daily sedation vacations were enacted, and the patient's mental status improved and was much better when TSH was around 20. The bilateral pleural effusions improved with aggressive diuresis. Breathing trials were initiated when the patient's fio2 requirements decreased to 60% and a PEEP of 8. She was eventually extubated onto BiPAP and then high-flow nasal cannula while off of BiPAP. Pericardial fluid remained stable, and no cardiac tamponade pathology developed. As a result, it was determined that a pericardial window was unnecessary. Furthermore, she was not a candidate for pericardiocentesis as the pericardial effusion was located posterior to the heart. Her renal failure improved with improved cardiac function, diuretics, and thyroid hormone replacement.

After extubation patient had speech and swallow evaluations and was able to resume an oral diet. The patient was eventually transferred out of the ICU to the general medical floor and eventually to a rehabilitation unit.

Despite the name myxedema coma, most patients will not present in a coma status. This illness is at its core a severe hypothyroidism crisis that leads to systemic multiorgan failure. Thyroid hormones T3, and to a lesser extent, T4 act directly on a cellular level to upregulate all metabolic processes in the body. Therefore, deficiency of this hormone is characterized by systemic decreased metabolism and decreased glucose utilization along with increased production and storage of osmotically active mucopolysaccharide protein complexes into peripheral tissues resulting in diffuse edema and swelling of tissue. [1]

Myxedema coma is an illness that occurs primarily in females at a rate of 4:1 compared to men. It typically impacts the elderly at the age of greater than 60 years old, and approximately 90% of cases occur during the winter months. Myxedema coma is the product of longstanding unidentified or undertreated hypothyroidism of any etiology. Thyroid hormone is necessary throughout the body and acts as a regulatory hormone that affects many organ systems. [2] In cardiac tissues, myxedema coma manifests as decreased contractility with subsequent reduction in stroke volume and overall cardiac output.  Bradycardia and hypotension are typically present also. Pericardial effusions occur due to the accumulation of mucopolysaccharides in the pericardial sac, which leads to worsened cardiac function and congestive heart failure from diastolic dysfunction. Capillary permeability is also increased throughout the body leading to worsened edema. Electrocardiogram findings may include bradycardia and low-voltage, non-specific ST waveform changes with possible inverted T waves.

Neurologic tissues are impacted in myxedema coma leading to the pathognomonic altered mental status resulting from hypoxia and decreased cerebral blood flow secondary to cardiac dysfunction as above. Additionally, hypothyroidism leads to decreased glucose uptake and utilization in neurological tissue, thus worsening cognitive function.

The pulmonary system typically manifests this disease process through hypoventilation secondary to the central nervous system (CNS) depression of the respiratory drive with blunting of the response to hypoxia and hypercapnia. Additionally, metabolic dysfunction in the muscles of respiration leads to respiratory fatigue and failure, macroglossia from mucopolysaccharide driven edema of the tongue leads to mechanical obstruction of the airway, and obesity hypoventilation syndrome with the decreased respiratory drive as most hypothyroid patients suffer from obesity.

Renal manifestations include decreased glomerular filtration rate from the reduced cardiac output and increased systemic vascular resistance coupled with acute rhabdomyolysis lead to acute kidney injury. In the case of our patient above who has a pre-existing renal disease status post-nephrectomy, this is further worsened.  The net effect is worsened fluid overload status compounding the cardiac dysfunction and edema. [3]

The gastrointestinal tract is marked by mucopolysaccharide-driven edema as well leading to malabsorption of nutrients, gastric ileus, and decreased peristalsis. Ascites is common because of increased capillary permeability in the intestines coupled with coexistent congestive heart failure and congestive hepatic failure. Coagulopathies are common to occur as a result of this hepatic dysfunction.

Evaluation: The diagnosis of myxedema coma, as with all other diseases, is heavily reliant on the history and physical exam. A past medical history including hypothyroidism is highly significant whenever decreased mental status or coma is identified. In the absence of identified hypothyroidism, myxedema coma is a diagnosis of exclusion when all other sources of coma have been ruled out. If myxedema coma is suspected, evaluation of thyroid-stimulating hormone (TSH), free thyroxine (T4), and serum cortisol is warranted. T4 will be extremely low. TSH is variable depending on the etiology of hypothyroidism, with a high TSH indicating primary hypothyroidism and a low or normal TSH indicating secondary etiologies. Cortisol may be low indicating adrenal insufficiency because of hypothyroidism.  [4]

Prognosis: Myxedema coma is a medical emergency. With proper and rapid diagnosis and initiation of therapy, the mortality rate is still as high as 25% to 50%. The most common cause of death is due to respiratory failure. The factors which suggest a poorer prognosis include increased age, persistent hypothermia, bradycardia, low score Glasgow Coma Scale, or multi-organ impairment indicated by high APACHE (Acute Physiology and Chronic Health Evaluation) II score. For these reasons, placement in an intensive care unit with a low threshold for intubation and mechanical ventilation can improve mortality outcomes. [3] [5]

• Pearls of Wisdom
• Not every case of shortness of breath is COPD or congestive heart failure (CHF). While less likely, a history of hypothyroidism should raise suspicion of myxedema coma in a patient with any cognitive changes.
• Myxedema is the great imitator illness that impacts all organ systems. It can easily be mistaken for congestive heart failure, COPD exacerbation, pneumonia, renal injury or failure, or neurological insult.
• Initial steps in therapy include aggressive airway management, thyroid hormone replacement, glucocorticoid therapy, and supportive measures.
• These patients should be monitored in an intensive care environment with continuous telemetry. [6]
• Enhancing Healthcare Team Outcomes

This case demonstrates how all interprofessional healthcare team members need to be involved in arriving at a correct diagnosis, particularly in more challenging cases such as this one. Clinicians, specialists, nurses, pharmacists, laboratory technicians all bear responsibility for carrying out the duties pertaining to their particular discipline and sharing any findings with all team members. An incorrect diagnosis will almost inevitably lead to incorrect treatment, so coordinated activity, open communication, and empowerment to voice concerns are all part of the dynamic that needs to drive such cases so patients will attain the best possible outcomes.

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Case Study of 60 year old female presenting with Shortness of Breath Contributed by Sandeep Sharma, MD

Disclosure: Deepa Rawat declares no relevant financial relationships with ineligible companies.

Disclosure: Sandeep Sharma declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Rawat D, Sharma S. Case Study: 60-Year-Old Female Presenting With Shortness of Breath. [Updated 2023 Feb 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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• Published: 17 April 2024

The economic commitment of climate change

• Maximilian Kotz   ORCID: orcid.org/0000-0003-2564-5043 1 , 2 ,
• Anders Levermann   ORCID: orcid.org/0000-0003-4432-4704 1 , 2 &
• Leonie Wenz   ORCID: orcid.org/0000-0002-8500-1568 1 , 3  

Nature volume  628 ,  pages 551–557 ( 2024 ) Cite this article

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• Environmental economics
• Environmental health
• Interdisciplinary studies
• Projection and prediction

Global projections of macroeconomic climate-change damages typically consider impacts from average annual and national temperatures over long time horizons 1 , 2 , 3 , 4 , 5 , 6 . Here we use recent empirical findings from more than 1,600 regions worldwide over the past 40 years to project sub-national damages from temperature and precipitation, including daily variability and extremes 7 , 8 . Using an empirical approach that provides a robust lower bound on the persistence of impacts on economic growth, we find that the world economy is committed to an income reduction of 19% within the next 26 years independent of future emission choices (relative to a baseline without climate impacts, likely range of 11–29% accounting for physical climate and empirical uncertainty). These damages already outweigh the mitigation costs required to limit global warming to 2 °C by sixfold over this near-term time frame and thereafter diverge strongly dependent on emission choices. Committed damages arise predominantly through changes in average temperature, but accounting for further climatic components raises estimates by approximately 50% and leads to stronger regional heterogeneity. Committed losses are projected for all regions except those at very high latitudes, at which reductions in temperature variability bring benefits. The largest losses are committed at lower latitudes in regions with lower cumulative historical emissions and lower present-day income.

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Climate damage projections beyond annual temperature

Investment incentive reduced by climate damages can be restored by optimal policy

Climate economics support for the UN climate targets

Projections of the macroeconomic damage caused by future climate change are crucial to informing public and policy debates about adaptation, mitigation and climate justice. On the one hand, adaptation against climate impacts must be justified and planned on the basis of an understanding of their future magnitude and spatial distribution 9 . This is also of importance in the context of climate justice 10 , as well as to key societal actors, including governments, central banks and private businesses, which increasingly require the inclusion of climate risks in their macroeconomic forecasts to aid adaptive decision-making 11 , 12 . On the other hand, climate mitigation policy such as the Paris Climate Agreement is often evaluated by balancing the costs of its implementation against the benefits of avoiding projected physical damages. This evaluation occurs both formally through cost–benefit analyses 1 , 4 , 5 , 6 , as well as informally through public perception of mitigation and damage costs 13 .

Projections of future damages meet challenges when informing these debates, in particular the human biases relating to uncertainty and remoteness that are raised by long-term perspectives 14 . Here we aim to overcome such challenges by assessing the extent of economic damages from climate change to which the world is already committed by historical emissions and socio-economic inertia (the range of future emission scenarios that are considered socio-economically plausible 15 ). Such a focus on the near term limits the large uncertainties about diverging future emission trajectories, the resulting long-term climate response and the validity of applying historically observed climate–economic relations over long timescales during which socio-technical conditions may change considerably. As such, this focus aims to simplify the communication and maximize the credibility of projected economic damages from future climate change.

In projecting the future economic damages from climate change, we make use of recent advances in climate econometrics that provide evidence for impacts on sub-national economic growth from numerous components of the distribution of daily temperature and precipitation 3 , 7 , 8 . Using fixed-effects panel regression models to control for potential confounders, these studies exploit within-region variation in local temperature and precipitation in a panel of more than 1,600 regions worldwide, comprising climate and income data over the past 40 years, to identify the plausibly causal effects of changes in several climate variables on economic productivity 16 , 17 . Specifically, macroeconomic impacts have been identified from changing daily temperature variability, total annual precipitation, the annual number of wet days and extreme daily rainfall that occur in addition to those already identified from changing average temperature 2 , 3 , 18 . Moreover, regional heterogeneity in these effects based on the prevailing local climatic conditions has been found using interactions terms. The selection of these climate variables follows micro-level evidence for mechanisms related to the impacts of average temperatures on labour and agricultural productivity 2 , of temperature variability on agricultural productivity and health 7 , as well as of precipitation on agricultural productivity, labour outcomes and flood damages 8 (see Extended Data Table 1 for an overview, including more detailed references). References  7 , 8 contain a more detailed motivation for the use of these particular climate variables and provide extensive empirical tests about the robustness and nature of their effects on economic output, which are summarized in Methods . By accounting for these extra climatic variables at the sub-national level, we aim for a more comprehensive description of climate impacts with greater detail across both time and space.

Constraining the persistence of impacts

A key determinant and source of discrepancy in estimates of the magnitude of future climate damages is the extent to which the impact of a climate variable on economic growth rates persists. The two extreme cases in which these impacts persist indefinitely or only instantaneously are commonly referred to as growth or level effects 19 , 20 (see Methods section ‘Empirical model specification: fixed-effects distributed lag models’ for mathematical definitions). Recent work shows that future damages from climate change depend strongly on whether growth or level effects are assumed 20 . Following refs.  2 , 18 , we provide constraints on this persistence by using distributed lag models to test the significance of delayed effects separately for each climate variable. Notably, and in contrast to refs.  2 , 18 , we use climate variables in their first-differenced form following ref.  3 , implying a dependence of the growth rate on a change in climate variables. This choice means that a baseline specification without any lags constitutes a model prior of purely level effects, in which a permanent change in the climate has only an instantaneous effect on the growth rate 3 , 19 , 21 . By including lags, one can then test whether any effects may persist further. This is in contrast to the specification used by refs.  2 , 18 , in which climate variables are used without taking the first difference, implying a dependence of the growth rate on the level of climate variables. In this alternative case, the baseline specification without any lags constitutes a model prior of pure growth effects, in which a change in climate has an infinitely persistent effect on the growth rate. Consequently, including further lags in this alternative case tests whether the initial growth impact is recovered 18 , 19 , 21 . Both of these specifications suffer from the limiting possibility that, if too few lags are included, one might falsely accept the model prior. The limitations of including a very large number of lags, including loss of data and increasing statistical uncertainty with an increasing number of parameters, mean that such a possibility is likely. By choosing a specification in which the model prior is one of level effects, our approach is therefore conservative by design, avoiding assumptions of infinite persistence of climate impacts on growth and instead providing a lower bound on this persistence based on what is observable empirically (see Methods section ‘Empirical model specification: fixed-effects distributed lag models’ for further exposition of this framework). The conservative nature of such a choice is probably the reason that ref.  19 finds much greater consistency between the impacts projected by models that use the first difference of climate variables, as opposed to their levels.

We begin our empirical analysis of the persistence of climate impacts on growth using ten lags of the first-differenced climate variables in fixed-effects distributed lag models. We detect substantial effects on economic growth at time lags of up to approximately 8–10 years for the temperature terms and up to approximately 4 years for the precipitation terms (Extended Data Fig. 1 and Extended Data Table 2 ). Furthermore, evaluation by means of information criteria indicates that the inclusion of all five climate variables and the use of these numbers of lags provide a preferable trade-off between best-fitting the data and including further terms that could cause overfitting, in comparison with model specifications excluding climate variables or including more or fewer lags (Extended Data Fig. 3 , Supplementary Methods Section  1 and Supplementary Table 1 ). We therefore remove statistically insignificant terms at later lags (Supplementary Figs. 1 – 3 and Supplementary Tables 2 – 4 ). Further tests using Monte Carlo simulations demonstrate that the empirical models are robust to autocorrelation in the lagged climate variables (Supplementary Methods Section  2 and Supplementary Figs. 4 and 5 ), that information criteria provide an effective indicator for lag selection (Supplementary Methods Section  2 and Supplementary Fig. 6 ), that the results are robust to concerns of imperfect multicollinearity between climate variables and that including several climate variables is actually necessary to isolate their separate effects (Supplementary Methods Section  3 and Supplementary Fig. 7 ). We provide a further robustness check using a restricted distributed lag model to limit oscillations in the lagged parameter estimates that may result from autocorrelation, finding that it provides similar estimates of cumulative marginal effects to the unrestricted model (Supplementary Methods Section 4 and Supplementary Figs. 8 and 9 ). Finally, to explicitly account for any outstanding uncertainty arising from the precise choice of the number of lags, we include empirical models with marginally different numbers of lags in the error-sampling procedure of our projection of future damages. On the basis of the lag-selection procedure (the significance of lagged terms in Extended Data Fig. 1 and Extended Data Table 2 , as well as information criteria in Extended Data Fig. 3 ), we sample from models with eight to ten lags for temperature and four for precipitation (models shown in Supplementary Figs. 1 – 3 and Supplementary Tables 2 – 4 ). In summary, this empirical approach to constrain the persistence of climate impacts on economic growth rates is conservative by design in avoiding assumptions of infinite persistence, but nevertheless provides a lower bound on the extent of impact persistence that is robust to the numerous tests outlined above.

Committed damages until mid-century

We combine these empirical economic response functions (Supplementary Figs. 1 – 3 and Supplementary Tables 2 – 4 ) with an ensemble of 21 climate models (see Supplementary Table 5 ) from the Coupled Model Intercomparison Project Phase 6 (CMIP-6) 22 to project the macroeconomic damages from these components of physical climate change (see Methods for further details). Bias-adjusted climate models that provide a highly accurate reproduction of observed climatological patterns with limited uncertainty (Supplementary Table 6 ) are used to avoid introducing biases in the projections. Following a well-developed literature 2 , 3 , 19 , these projections do not aim to provide a prediction of future economic growth. Instead, they are a projection of the exogenous impact of future climate conditions on the economy relative to the baselines specified by socio-economic projections, based on the plausibly causal relationships inferred by the empirical models and assuming ceteris paribus. Other exogenous factors relevant for the prediction of economic output are purposefully assumed constant.

A Monte Carlo procedure that samples from climate model projections, empirical models with different numbers of lags and model parameter estimates (obtained by 1,000 block-bootstrap resamples of each of the regressions in Supplementary Figs. 1 – 3 and Supplementary Tables 2 – 4 ) is used to estimate the combined uncertainty from these sources. Given these uncertainty distributions, we find that projected global damages are statistically indistinguishable across the two most extreme emission scenarios until 2049 (at the 5% significance level; Fig. 1 ). As such, the climate damages occurring before this time constitute those to which the world is already committed owing to the combination of past emissions and the range of future emission scenarios that are considered socio-economically plausible 15 . These committed damages comprise a permanent income reduction of 19% on average globally (population-weighted average) in comparison with a baseline without climate-change impacts (with a likely range of 11–29%, following the likelihood classification adopted by the Intergovernmental Panel on Climate Change (IPCC); see caption of Fig. 1 ). Even though levels of income per capita generally still increase relative to those of today, this constitutes a permanent income reduction for most regions, including North America and Europe (each with median income reductions of approximately 11%) and with South Asia and Africa being the most strongly affected (each with median income reductions of approximately 22%; Fig. 1 ). Under a middle-of-the road scenario of future income development (SSP2, in which SSP stands for Shared Socio-economic Pathway), this corresponds to global annual damages in 2049 of 38 trillion in 2005 international dollars (likely range of 19–59 trillion 2005 international dollars). Compared with empirical specifications that assume pure growth or pure level effects, our preferred specification that provides a robust lower bound on the extent of climate impact persistence produces damages between these two extreme assumptions (Extended Data Fig. 3 ).

Estimates of the projected reduction in income per capita from changes in all climate variables based on empirical models of climate impacts on economic output with a robust lower bound on their persistence (Extended Data Fig. 1 ) under a low-emission scenario compatible with the 2 °C warming target and a high-emission scenario (SSP2-RCP2.6 and SSP5-RCP8.5, respectively) are shown in purple and orange, respectively. Shading represents the 34% and 10% confidence intervals reflecting the likely and very likely ranges, respectively (following the likelihood classification adopted by the IPCC), having estimated uncertainty from a Monte Carlo procedure, which samples the uncertainty from the choice of physical climate models, empirical models with different numbers of lags and bootstrapped estimates of the regression parameters shown in Supplementary Figs. 1 – 3 . Vertical dashed lines show the time at which the climate damages of the two emission scenarios diverge at the 5% and 1% significance levels based on the distribution of differences between emission scenarios arising from the uncertainty sampling discussed above. Note that uncertainty in the difference of the two scenarios is smaller than the combined uncertainty of the two respective scenarios because samples of the uncertainty (climate model and empirical model choice, as well as model parameter bootstrap) are consistent across the two emission scenarios, hence the divergence of damages occurs while the uncertainty bounds of the two separate damage scenarios still overlap. Estimates of global mitigation costs from the three IAMs that provide results for the SSP2 baseline and SSP2-RCP2.6 scenario are shown in light green in the top panel, with the median of these estimates shown in bold.

Damages already outweigh mitigation costs

We compare the damages to which the world is committed over the next 25 years to estimates of the mitigation costs required to achieve the Paris Climate Agreement. Taking estimates of mitigation costs from the three integrated assessment models (IAMs) in the IPCC AR6 database 23 that provide results under comparable scenarios (SSP2 baseline and SSP2-RCP2.6, in which RCP stands for Representative Concentration Pathway), we find that the median committed climate damages are larger than the median mitigation costs in 2050 (six trillion in 2005 international dollars) by a factor of approximately six (note that estimates of mitigation costs are only provided every 10 years by the IAMs and so a comparison in 2049 is not possible). This comparison simply aims to compare the magnitude of future damages against mitigation costs, rather than to conduct a formal cost–benefit analysis of transitioning from one emission path to another. Formal cost–benefit analyses typically find that the net benefits of mitigation only emerge after 2050 (ref.  5 ), which may lead some to conclude that physical damages from climate change are simply not large enough to outweigh mitigation costs until the second half of the century. Our simple comparison of their magnitudes makes clear that damages are actually already considerably larger than mitigation costs and the delayed emergence of net mitigation benefits results primarily from the fact that damages across different emission paths are indistinguishable until mid-century (Fig. 1 ).

Although these near-term damages constitute those to which the world is already committed, we note that damage estimates diverge strongly across emission scenarios after 2049, conveying the clear benefits of mitigation from a purely economic point of view that have been emphasized in previous studies 4 , 24 . As well as the uncertainties assessed in Fig. 1 , these conclusions are robust to structural choices, such as the timescale with which changes in the moderating variables of the empirical models are estimated (Supplementary Figs. 10 and 11 ), as well as the order in which one accounts for the intertemporal and international components of currency comparison (Supplementary Fig. 12 ; see Methods for further details).

Damages from variability and extremes

Committed damages primarily arise through changes in average temperature (Fig. 2 ). This reflects the fact that projected changes in average temperature are larger than those in other climate variables when expressed as a function of their historical interannual variability (Extended Data Fig. 4 ). Because the historical variability is that on which the empirical models are estimated, larger projected changes in comparison with this variability probably lead to larger future impacts in a purely statistical sense. From a mechanistic perspective, one may plausibly interpret this result as implying that future changes in average temperature are the most unprecedented from the perspective of the historical fluctuations to which the economy is accustomed and therefore will cause the most damage. This insight may prove useful in terms of guiding adaptation measures to the sources of greatest damage.

Estimates of the median projected reduction in sub-national income per capita across emission scenarios (SSP2-RCP2.6 and SSP2-RCP8.5) as well as climate model, empirical model and model parameter uncertainty in the year in which climate damages diverge at the 5% level (2049, as identified in Fig. 1 ). a , Impacts arising from all climate variables. b – f , Impacts arising separately from changes in annual mean temperature ( b ), daily temperature variability ( c ), total annual precipitation ( d ), the annual number of wet days (>1 mm) ( e ) and extreme daily rainfall ( f ) (see Methods for further definitions). Data on national administrative boundaries are obtained from the GADM database version 3.6 and are freely available for academic use ( https://gadm.org/ ).

Nevertheless, future damages based on empirical models that consider changes in annual average temperature only and exclude the other climate variables constitute income reductions of only 13% in 2049 (Extended Data Fig. 5a , likely range 5–21%). This suggests that accounting for the other components of the distribution of temperature and precipitation raises net damages by nearly 50%. This increase arises through the further damages that these climatic components cause, but also because their inclusion reveals a stronger negative economic response to average temperatures (Extended Data Fig. 5b ). The latter finding is consistent with our Monte Carlo simulations, which suggest that the magnitude of the effect of average temperature on economic growth is underestimated unless accounting for the impacts of other correlated climate variables (Supplementary Fig. 7 ).

In terms of the relative contributions of the different climatic components to overall damages, we find that accounting for daily temperature variability causes the largest increase in overall damages relative to empirical frameworks that only consider changes in annual average temperature (4.9 percentage points, likely range 2.4–8.7 percentage points, equivalent to approximately 10 trillion international dollars). Accounting for precipitation causes smaller increases in overall damages, which are—nevertheless—equivalent to approximately 1.2 trillion international dollars: 0.01 percentage points (−0.37–0.33 percentage points), 0.34 percentage points (0.07–0.90 percentage points) and 0.36 percentage points (0.13–0.65 percentage points) from total annual precipitation, the number of wet days and extreme daily precipitation, respectively. Moreover, climate models seem to underestimate future changes in temperature variability 25 and extreme precipitation 26 , 27 in response to anthropogenic forcing as compared with that observed historically, suggesting that the true impacts from these variables may be larger.

The distribution of committed damages

The spatial distribution of committed damages (Fig. 2a ) reflects a complex interplay between the patterns of future change in several climatic components and those of historical economic vulnerability to changes in those variables. Damages resulting from increasing annual mean temperature (Fig. 2b ) are negative almost everywhere globally, and larger at lower latitudes in regions in which temperatures are already higher and economic vulnerability to temperature increases is greatest (see the response heterogeneity to mean temperature embodied in Extended Data Fig. 1a ). This occurs despite the amplified warming projected at higher latitudes 28 , suggesting that regional heterogeneity in economic vulnerability to temperature changes outweighs heterogeneity in the magnitude of future warming (Supplementary Fig. 13a ). Economic damages owing to daily temperature variability (Fig. 2c ) exhibit a strong latitudinal polarisation, primarily reflecting the physical response of daily variability to greenhouse forcing in which increases in variability across lower latitudes (and Europe) contrast decreases at high latitudes 25 (Supplementary Fig. 13b ). These two temperature terms are the dominant determinants of the pattern of overall damages (Fig. 2a ), which exhibits a strong polarity with damages across most of the globe except at the highest northern latitudes. Future changes in total annual precipitation mainly bring economic benefits except in regions of drying, such as the Mediterranean and central South America (Fig. 2d and Supplementary Fig. 13c ), but these benefits are opposed by changes in the number of wet days, which produce damages with a similar pattern of opposite sign (Fig. 2e and Supplementary Fig. 13d ). By contrast, changes in extreme daily rainfall produce damages in all regions, reflecting the intensification of daily rainfall extremes over global land areas 29 , 30 (Fig. 2f and Supplementary Fig. 13e ).

The spatial distribution of committed damages implies considerable injustice along two dimensions: culpability for the historical emissions that have caused climate change and pre-existing levels of socio-economic welfare. Spearman’s rank correlations indicate that committed damages are significantly larger in countries with smaller historical cumulative emissions, as well as in regions with lower current income per capita (Fig. 3 ). This implies that those countries that will suffer the most from the damages already committed are those that are least responsible for climate change and which also have the least resources to adapt to it.

Estimates of the median projected change in national income per capita across emission scenarios (RCP2.6 and RCP8.5) as well as climate model, empirical model and model parameter uncertainty in the year in which climate damages diverge at the 5% level (2049, as identified in Fig. 1 ) are plotted against cumulative national emissions per capita in 2020 (from the Global Carbon Project) and coloured by national income per capita in 2020 (from the World Bank) in a and vice versa in b . In each panel, the size of each scatter point is weighted by the national population in 2020 (from the World Bank). Inset numbers indicate the Spearman’s rank correlation ρ and P -values for a hypothesis test whose null hypothesis is of no correlation, as well as the Spearman’s rank correlation weighted by national population.

To further quantify this heterogeneity, we assess the difference in committed damages between the upper and lower quartiles of regions when ranked by present income levels and historical cumulative emissions (using a population weighting to both define the quartiles and estimate the group averages). On average, the quartile of countries with lower income are committed to an income loss that is 8.9 percentage points (or 61%) greater than the upper quartile (Extended Data Fig. 6 ), with a likely range of 3.8–14.7 percentage points across the uncertainty sampling of our damage projections (following the likelihood classification adopted by the IPCC). Similarly, the quartile of countries with lower historical cumulative emissions are committed to an income loss that is 6.9 percentage points (or 40%) greater than the upper quartile, with a likely range of 0.27–12 percentage points. These patterns reemphasize the prevalence of injustice in climate impacts 31 , 32 , 33 in the context of the damages to which the world is already committed by historical emissions and socio-economic inertia.

Contextualizing the magnitude of damages

The magnitude of projected economic damages exceeds previous literature estimates 2 , 3 , arising from several developments made on previous approaches. Our estimates are larger than those of ref.  2 (see first row of Extended Data Table 3 ), primarily because of the facts that sub-national estimates typically show a steeper temperature response (see also refs.  3 , 34 ) and that accounting for other climatic components raises damage estimates (Extended Data Fig. 5 ). However, we note that our empirical approach using first-differenced climate variables is conservative compared with that of ref.  2 in regard to the persistence of climate impacts on growth (see introduction and Methods section ‘Empirical model specification: fixed-effects distributed lag models’), an important determinant of the magnitude of long-term damages 19 , 21 . Using a similar empirical specification to ref.  2 , which assumes infinite persistence while maintaining the rest of our approach (sub-national data and further climate variables), produces considerably larger damages (purple curve of Extended Data Fig. 3 ). Compared with studies that do take the first difference of climate variables 3 , 35 , our estimates are also larger (see second and third rows of Extended Data Table 3 ). The inclusion of further climate variables (Extended Data Fig. 5 ) and a sufficient number of lags to more adequately capture the extent of impact persistence (Extended Data Figs. 1 and 2 ) are the main sources of this difference, as is the use of specifications that capture nonlinearities in the temperature response when compared with ref.  35 . In summary, our estimates develop on previous studies by incorporating the latest data and empirical insights 7 , 8 , as well as in providing a robust empirical lower bound on the persistence of impacts on economic growth, which constitutes a middle ground between the extremes of the growth-versus-levels debate 19 , 21 (Extended Data Fig. 3 ).

Compared with the fraction of variance explained by the empirical models historically (<5%), the projection of reductions in income of 19% may seem large. This arises owing to the fact that projected changes in climatic conditions are much larger than those that were experienced historically, particularly for changes in average temperature (Extended Data Fig. 4 ). As such, any assessment of future climate-change impacts necessarily requires an extrapolation outside the range of the historical data on which the empirical impact models were evaluated. Nevertheless, these models constitute the most state-of-the-art methods for inference of plausibly causal climate impacts based on observed data. Moreover, we take explicit steps to limit out-of-sample extrapolation by capping the moderating variables of the interaction terms at the 95th percentile of the historical distribution (see Methods ). This avoids extrapolating the marginal effects outside what was observed historically. Given the nonlinear response of economic output to annual mean temperature (Extended Data Fig. 1 and Extended Data Table 2 ), this is a conservative choice that limits the magnitude of damages that we project. Furthermore, back-of-the-envelope calculations indicate that the projected damages are consistent with the magnitude and patterns of historical economic development (see Supplementary Discussion Section  5 ).

Missing impacts and spatial spillovers

Despite assessing several climatic components from which economic impacts have recently been identified 3 , 7 , 8 , this assessment of aggregate climate damages should not be considered comprehensive. Important channels such as impacts from heatwaves 31 , sea-level rise 36 , tropical cyclones 37 and tipping points 38 , 39 , as well as non-market damages such as those to ecosystems 40 and human health 41 , are not considered in these estimates. Sea-level rise is unlikely to be feasibly incorporated into empirical assessments such as this because historical sea-level variability is mostly small. Non-market damages are inherently intractable within our estimates of impacts on aggregate monetary output and estimates of these impacts could arguably be considered as extra to those identified here. Recent empirical work suggests that accounting for these channels would probably raise estimates of these committed damages, with larger damages continuing to arise in the global south 31 , 36 , 37 , 38 , 39 , 40 , 41 , 42 .

Moreover, our main empirical analysis does not explicitly evaluate the potential for impacts in local regions to produce effects that ‘spill over’ into other regions. Such effects may further mitigate or amplify the impacts we estimate, for example, if companies relocate production from one affected region to another or if impacts propagate along supply chains. The current literature indicates that trade plays a substantial role in propagating spillover effects 43 , 44 , making their assessment at the sub-national level challenging without available data on sub-national trade dependencies. Studies accounting for only spatially adjacent neighbours indicate that negative impacts in one region induce further negative impacts in neighbouring regions 45 , 46 , 47 , 48 , suggesting that our projected damages are probably conservative by excluding these effects. In Supplementary Fig. 14 , we assess spillovers from neighbouring regions using a spatial-lag model. For simplicity, this analysis excludes temporal lags, focusing only on contemporaneous effects. The results show that accounting for spatial spillovers can amplify the overall magnitude, and also the heterogeneity, of impacts. Consistent with previous literature, this indicates that the overall magnitude (Fig. 1 ) and heterogeneity (Fig. 3 ) of damages that we project in our main specification may be conservative without explicitly accounting for spillovers. We note that further analysis that addresses both spatially and trade-connected spillovers, while also accounting for delayed impacts using temporal lags, would be necessary to adequately address this question fully. These approaches offer fruitful avenues for further research but are beyond the scope of this manuscript, which primarily aims to explore the impacts of different climate conditions and their persistence.

Policy implications

We find that the economic damages resulting from climate change until 2049 are those to which the world economy is already committed and that these greatly outweigh the costs required to mitigate emissions in line with the 2 °C target of the Paris Climate Agreement (Fig. 1 ). This assessment is complementary to formal analyses of the net costs and benefits associated with moving from one emission path to another, which typically find that net benefits of mitigation only emerge in the second half of the century 5 . Our simple comparison of the magnitude of damages and mitigation costs makes clear that this is primarily because damages are indistinguishable across emissions scenarios—that is, committed—until mid-century (Fig. 1 ) and that they are actually already much larger than mitigation costs. For simplicity, and owing to the availability of data, we compare damages to mitigation costs at the global level. Regional estimates of mitigation costs may shed further light on the national incentives for mitigation to which our results already hint, of relevance for international climate policy. Although these damages are committed from a mitigation perspective, adaptation may provide an opportunity to reduce them. Moreover, the strong divergence of damages after mid-century reemphasizes the clear benefits of mitigation from a purely economic perspective, as highlighted in previous studies 1 , 4 , 6 , 24 .

Historical climate data

Historical daily 2-m temperature and precipitation totals (in mm) are obtained for the period 1979–2019 from the W5E5 database. The W5E5 dataset comes from ERA-5, a state-of-the-art reanalysis of historical observations, but has been bias-adjusted by applying version 2.0 of the WATCH Forcing Data to ERA-5 reanalysis data and precipitation data from version 2.3 of the Global Precipitation Climatology Project to better reflect ground-based measurements 49 , 50 , 51 . We obtain these data on a 0.5° × 0.5° grid from the Inter-Sectoral Impact Model Intercomparison Project (ISIMIP) database. Notably, these historical data have been used to bias-adjust future climate projections from CMIP-6 (see the following section), ensuring consistency between the distribution of historical daily weather on which our empirical models were estimated and the climate projections used to estimate future damages. These data are publicly available from the ISIMIP database. See refs.  7 , 8 for robustness tests of the empirical models to the choice of climate data reanalysis products.

Future climate data

Daily 2-m temperature and precipitation totals (in mm) are taken from 21 climate models participating in CMIP-6 under a high (RCP8.5) and a low (RCP2.6) greenhouse gas emission scenario from 2015 to 2100. The data have been bias-adjusted and statistically downscaled to a common half-degree grid to reflect the historical distribution of daily temperature and precipitation of the W5E5 dataset using the trend-preserving method developed by the ISIMIP 50 , 52 . As such, the climate model data reproduce observed climatological patterns exceptionally well (Supplementary Table 5 ). Gridded data are publicly available from the ISIMIP database.

Historical economic data

Historical economic data come from the DOSE database of sub-national economic output 53 . We use a recent revision to the DOSE dataset that provides data across 83 countries, 1,660 sub-national regions with varying temporal coverage from 1960 to 2019. Sub-national units constitute the first administrative division below national, for example, states for the USA and provinces for China. Data come from measures of gross regional product per capita (GRPpc) or income per capita in local currencies, reflecting the values reported in national statistical agencies, yearbooks and, in some cases, academic literature. We follow previous literature 3 , 7 , 8 , 54 and assess real sub-national output per capita by first converting values from local currencies to US dollars to account for diverging national inflationary tendencies and then account for US inflation using a US deflator. Alternatively, one might first account for national inflation and then convert between currencies. Supplementary Fig. 12 demonstrates that our conclusions are consistent when accounting for price changes in the reversed order, although the magnitude of estimated damages varies. See the documentation of the DOSE dataset for further discussion of these choices. Conversions between currencies are conducted using exchange rates from the FRED database of the Federal Reserve Bank of St. Louis 55 and the national deflators from the World Bank 56 .

Future socio-economic data

Baseline gridded gross domestic product (GDP) and population data for the period 2015–2100 are taken from the middle-of-the-road scenario SSP2 (ref.  15 ). Population data have been downscaled to a half-degree grid by the ISIMIP following the methodologies of refs.  57 , 58 , which we then aggregate to the sub-national level of our economic data using the spatial aggregation procedure described below. Because current methodologies for downscaling the GDP of the SSPs use downscaled population to do so, per-capita estimates of GDP with a realistic distribution at the sub-national level are not readily available for the SSPs. We therefore use national-level GDP per capita (GDPpc) projections for all sub-national regions of a given country, assuming homogeneity within countries in terms of baseline GDPpc. Here we use projections that have been updated to account for the impact of the COVID-19 pandemic on the trajectory of future income, while remaining consistent with the long-term development of the SSPs 59 . The choice of baseline SSP alters the magnitude of projected climate damages in monetary terms, but when assessed in terms of percentage change from the baseline, the choice of socio-economic scenario is inconsequential. Gridded SSP population data and national-level GDPpc data are publicly available from the ISIMIP database. Sub-national estimates as used in this study are available in the code and data replication files.

Climate variables

Following recent literature 3 , 7 , 8 , we calculate an array of climate variables for which substantial impacts on macroeconomic output have been identified empirically, supported by further evidence at the micro level for plausible underlying mechanisms. See refs.  7 , 8 for an extensive motivation for the use of these particular climate variables and for detailed empirical tests on the nature and robustness of their effects on economic output. To summarize, these studies have found evidence for independent impacts on economic growth rates from annual average temperature, daily temperature variability, total annual precipitation, the annual number of wet days and extreme daily rainfall. Assessments of daily temperature variability were motivated by evidence of impacts on agricultural output and human health, as well as macroeconomic literature on the impacts of volatility on growth when manifest in different dimensions, such as government spending, exchange rates and even output itself 7 . Assessments of precipitation impacts were motivated by evidence of impacts on agricultural productivity, metropolitan labour outcomes and conflict, as well as damages caused by flash flooding 8 . See Extended Data Table 1 for detailed references to empirical studies of these physical mechanisms. Marked impacts of daily temperature variability, total annual precipitation, the number of wet days and extreme daily rainfall on macroeconomic output were identified robustly across different climate datasets, spatial aggregation schemes, specifications of regional time trends and error-clustering approaches. They were also found to be robust to the consideration of temperature extremes 7 , 8 . Furthermore, these climate variables were identified as having independent effects on economic output 7 , 8 , which we further explain here using Monte Carlo simulations to demonstrate the robustness of the results to concerns of imperfect multicollinearity between climate variables (Supplementary Methods Section  2 ), as well as by using information criteria (Supplementary Table 1 ) to demonstrate that including several lagged climate variables provides a preferable trade-off between optimally describing the data and limiting the possibility of overfitting.

We calculate these variables from the distribution of daily, d , temperature, T x , d , and precipitation, P x , d , at the grid-cell, x , level for both the historical and future climate data. As well as annual mean temperature, \({\bar{T}}_{x,y}\) , and annual total precipitation, P x , y , we calculate annual, y , measures of daily temperature variability, \({\widetilde{T}}_{x,y}\) :

the number of wet days, Pwd x , y :

and extreme daily rainfall:

in which T x , d , m , y is the grid-cell-specific daily temperature in month m and year y , \({\bar{T}}_{x,m,{y}}\) is the year and grid-cell-specific monthly, m , mean temperature, D m and D y the number of days in a given month m or year y , respectively, H the Heaviside step function, 1 mm the threshold used to define wet days and P 99.9 x is the 99.9th percentile of historical (1979–2019) daily precipitation at the grid-cell level. Units of the climate measures are degrees Celsius for annual mean temperature and daily temperature variability, millimetres for total annual precipitation and extreme daily precipitation, and simply the number of days for the annual number of wet days.

We also calculated weighted standard deviations of monthly rainfall totals as also used in ref.  8 but do not include them in our projections as we find that, when accounting for delayed effects, their effect becomes statistically indistinct and is better captured by changes in total annual rainfall.

Spatial aggregation

We aggregate grid-cell-level historical and future climate measures, as well as grid-cell-level future GDPpc and population, to the level of the first administrative unit below national level of the GADM database, using an area-weighting algorithm that estimates the portion of each grid cell falling within an administrative boundary. We use this as our baseline specification following previous findings that the effect of area or population weighting at the sub-national level is negligible 7 , 8 .

Empirical model specification: fixed-effects distributed lag models

Following a wide range of climate econometric literature 16 , 60 , we use panel regression models with a selection of fixed effects and time trends to isolate plausibly exogenous variation with which to maximize confidence in a causal interpretation of the effects of climate on economic growth rates. The use of region fixed effects, μ r , accounts for unobserved time-invariant differences between regions, such as prevailing climatic norms and growth rates owing to historical and geopolitical factors. The use of yearly fixed effects, η y , accounts for regionally invariant annual shocks to the global climate or economy such as the El Niño–Southern Oscillation or global recessions. In our baseline specification, we also include region-specific linear time trends, k r y , to exclude the possibility of spurious correlations resulting from common slow-moving trends in climate and growth.

The persistence of climate impacts on economic growth rates is a key determinant of the long-term magnitude of damages. Methods for inferring the extent of persistence in impacts on growth rates have typically used lagged climate variables to evaluate the presence of delayed effects or catch-up dynamics 2 , 18 . For example, consider starting from a model in which a climate condition, C r , y , (for example, annual mean temperature) affects the growth rate, Δlgrp r , y (the first difference of the logarithm of gross regional product) of region r in year y :

which we refer to as a ‘pure growth effects’ model in the main text. Typically, further lags are included,

and the cumulative effect of all lagged terms is evaluated to assess the extent to which climate impacts on growth rates persist. Following ref.  18 , in the case that,

the implication is that impacts on the growth rate persist up to NL years after the initial shock (possibly to a weaker or a stronger extent), whereas if

then the initial impact on the growth rate is recovered after NL years and the effect is only one on the level of output. However, we note that such approaches are limited by the fact that, when including an insufficient number of lags to detect a recovery of the growth rates, one may find equation ( 6 ) to be satisfied and incorrectly assume that a change in climatic conditions affects the growth rate indefinitely. In practice, given a limited record of historical data, including too few lags to confidently conclude in an infinitely persistent impact on the growth rate is likely, particularly over the long timescales over which future climate damages are often projected 2 , 24 . To avoid this issue, we instead begin our analysis with a model for which the level of output, lgrp r , y , depends on the level of a climate variable, C r , y :

Given the non-stationarity of the level of output, we follow the literature 19 and estimate such an equation in first-differenced form as,

which we refer to as a model of ‘pure level effects’ in the main text. This model constitutes a baseline specification in which a permanent change in the climate variable produces an instantaneous impact on the growth rate and a permanent effect only on the level of output. By including lagged variables in this specification,

we are able to test whether the impacts on the growth rate persist any further than instantaneously by evaluating whether α L  > 0 are statistically significantly different from zero. Even though this framework is also limited by the possibility of including too few lags, the choice of a baseline model specification in which impacts on the growth rate do not persist means that, in the case of including too few lags, the framework reverts to the baseline specification of level effects. As such, this framework is conservative with respect to the persistence of impacts and the magnitude of future damages. It naturally avoids assumptions of infinite persistence and we are able to interpret any persistence that we identify with equation ( 9 ) as a lower bound on the extent of climate impact persistence on growth rates. See the main text for further discussion of this specification choice, in particular about its conservative nature compared with previous literature estimates, such as refs.  2 , 18 .

We allow the response to climatic changes to vary across regions, using interactions of the climate variables with historical average (1979–2019) climatic conditions reflecting heterogenous effects identified in previous work 7 , 8 . Following this previous work, the moderating variables of these interaction terms constitute the historical average of either the variable itself or of the seasonal temperature difference, \({\hat{T}}_{r}\) , or annual mean temperature, \({\bar{T}}_{r}\) , in the case of daily temperature variability 7 and extreme daily rainfall, respectively 8 .

The resulting regression equation with N and M lagged variables, respectively, reads:

in which Δlgrp r , y is the annual, regional GRPpc growth rate, measured as the first difference of the logarithm of real GRPpc, following previous work 2 , 3 , 7 , 8 , 18 , 19 . Fixed-effects regressions were run using the fixest package in R (ref.  61 ).

Estimates of the coefficients of interest α i , L are shown in Extended Data Fig. 1 for N  =  M  = 10 lags and for our preferred choice of the number of lags in Supplementary Figs. 1 – 3 . In Extended Data Fig. 1 , errors are shown clustered at the regional level, but for the construction of damage projections, we block-bootstrap the regressions by region 1,000 times to provide a range of parameter estimates with which to sample the projection uncertainty (following refs.  2 , 31 ).

Spatial-lag model

In Supplementary Fig. 14 , we present the results from a spatial-lag model that explores the potential for climate impacts to ‘spill over’ into spatially neighbouring regions. We measure the distance between centroids of each pair of sub-national regions and construct spatial lags that take the average of the first-differenced climate variables and their interaction terms over neighbouring regions that are at distances of 0–500, 500–1,000, 1,000–1,500 and 1,500–2000 km (spatial lags, ‘SL’, 1 to 4). For simplicity, we then assess a spatial-lag model without temporal lags to assess spatial spillovers of contemporaneous climate impacts. This model takes the form:

in which SL indicates the spatial lag of each climate variable and interaction term. In Supplementary Fig. 14 , we plot the cumulative marginal effect of each climate variable at different baseline climate conditions by summing the coefficients for each climate variable and interaction term, for example, for average temperature impacts as:

These cumulative marginal effects can be regarded as the overall spatially dependent impact to an individual region given a one-unit shock to a climate variable in that region and all neighbouring regions at a given value of the moderating variable of the interaction term.

Constructing projections of economic damage from future climate change

We construct projections of future climate damages by applying the coefficients estimated in equation ( 10 ) and shown in Supplementary Tables 2 – 4 (when including only lags with statistically significant effects in specifications that limit overfitting; see Supplementary Methods Section  1 ) to projections of future climate change from the CMIP-6 models. Year-on-year changes in each primary climate variable of interest are calculated to reflect the year-to-year variations used in the empirical models. 30-year moving averages of the moderating variables of the interaction terms are calculated to reflect the long-term average of climatic conditions that were used for the moderating variables in the empirical models. By using moving averages in the projections, we account for the changing vulnerability to climate shocks based on the evolving long-term conditions (Supplementary Figs. 10 and 11 show that the results are robust to the precise choice of the window of this moving average). Although these climate variables are not differenced, the fact that the bias-adjusted climate models reproduce observed climatological patterns across regions for these moderating variables very accurately (Supplementary Table 6 ) with limited spread across models (<3%) precludes the possibility that any considerable bias or uncertainty is introduced by this methodological choice. However, we impose caps on these moderating variables at the 95th percentile at which they were observed in the historical data to prevent extrapolation of the marginal effects outside the range in which the regressions were estimated. This is a conservative choice that limits the magnitude of our damage projections.

Time series of primary climate variables and moderating climate variables are then combined with estimates of the empirical model parameters to evaluate the regression coefficients in equation ( 10 ), producing a time series of annual GRPpc growth-rate reductions for a given emission scenario, climate model and set of empirical model parameters. The resulting time series of growth-rate impacts reflects those occurring owing to future climate change. By contrast, a future scenario with no climate change would be one in which climate variables do not change (other than with random year-to-year fluctuations) and hence the time-averaged evaluation of equation ( 10 ) would be zero. Our approach therefore implicitly compares the future climate-change scenario to this no-climate-change baseline scenario.

The time series of growth-rate impacts owing to future climate change in region r and year y , δ r , y , are then added to the future baseline growth rates, π r , y (in log-diff form), obtained from the SSP2 scenario to yield trajectories of damaged GRPpc growth rates, ρ r , y . These trajectories are aggregated over time to estimate the future trajectory of GRPpc with future climate impacts:

in which GRPpc r , y =2020 is the initial log level of GRPpc. We begin damage estimates in 2020 to reflect the damages occurring since the end of the period for which we estimate the empirical models (1979–2019) and to match the timing of mitigation-cost estimates from most IAMs (see below).

For each emission scenario, this procedure is repeated 1,000 times while randomly sampling from the selection of climate models, the selection of empirical models with different numbers of lags (shown in Supplementary Figs. 1 – 3 and Supplementary Tables 2 – 4 ) and bootstrapped estimates of the regression parameters. The result is an ensemble of future GRPpc trajectories that reflect uncertainty from both physical climate change and the structural and sampling uncertainty of the empirical models.

Estimates of mitigation costs

We obtain IPCC estimates of the aggregate costs of emission mitigation from the AR6 Scenario Explorer and Database hosted by IIASA 23 . Specifically, we search the AR6 Scenarios Database World v1.1 for IAMs that provided estimates of global GDP and population under both a SSP2 baseline and a SSP2-RCP2.6 scenario to maintain consistency with the socio-economic and emission scenarios of the climate damage projections. We find five IAMs that provide data for these scenarios, namely, MESSAGE-GLOBIOM 1.0, REMIND-MAgPIE 1.5, AIM/GCE 2.0, GCAM 4.2 and WITCH-GLOBIOM 3.1. Of these five IAMs, we use the results only from the first three that passed the IPCC vetting procedure for reproducing historical emission and climate trajectories. We then estimate global mitigation costs as the percentage difference in global per capita GDP between the SSP2 baseline and the SSP2-RCP2.6 emission scenario. In the case of one of these IAMs, estimates of mitigation costs begin in 2020, whereas in the case of two others, mitigation costs begin in 2010. The mitigation cost estimates before 2020 in these two IAMs are mostly negligible, and our choice to begin comparison with damage estimates in 2020 is conservative with respect to the relative weight of climate damages compared with mitigation costs for these two IAMs.

Data availability

Data on economic production and ERA-5 climate data are publicly available at https://doi.org/10.5281/zenodo.4681306 (ref. 62 ) and https://www.ecmwf.int/en/forecasts/datasets/reanalysis-datasets/era5 , respectively. Data on mitigation costs are publicly available at https://data.ene.iiasa.ac.at/ar6/#/downloads . Processed climate and economic data, as well as all other necessary data for reproduction of the results, are available at the public repository https://doi.org/10.5281/zenodo.10562951  (ref. 63 ).

Code availability

All code necessary for reproduction of the results is available at the public repository https://doi.org/10.5281/zenodo.10562951  (ref. 63 ).

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Acknowledgements

We gratefully acknowledge financing from the Volkswagen Foundation and the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH on behalf of the Government of the Federal Republic of Germany and Federal Ministry for Economic Cooperation and Development (BMZ).

Open access funding provided by Potsdam-Institut für Klimafolgenforschung (PIK) e.V.

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Extended data figures and tables

Extended data fig. 1 constraining the persistence of historical climate impacts on economic growth rates..

The results of a panel-based fixed-effects distributed lag model for the effects of annual mean temperature ( a ), daily temperature variability ( b ), total annual precipitation ( c ), the number of wet days ( d ) and extreme daily precipitation ( e ) on sub-national economic growth rates. Point estimates show the effects of a 1 °C or one standard deviation increase (for temperature and precipitation variables, respectively) at the lower quartile, median and upper quartile of the relevant moderating variable (green, orange and purple, respectively) at different lagged periods after the initial shock (note that these are not cumulative effects). Climate variables are used in their first-differenced form (see main text for discussion) and the moderating climate variables are the annual mean temperature, seasonal temperature difference, total annual precipitation, number of wet days and annual mean temperature, respectively, in panels a – e (see Methods for further discussion). Error bars show the 95% confidence intervals having clustered standard errors by region. The within-region R 2 , Bayesian and Akaike information criteria for the model are shown at the top of the figure. This figure shows results with ten lags for each variable to demonstrate the observed levels of persistence, but our preferred specifications remove later lags based on the statistical significance of terms shown above and the information criteria shown in Extended Data Fig. 2 . The resulting models without later lags are shown in Supplementary Figs. 1 – 3 .

Extended Data Fig. 2 Incremental lag-selection procedure using information criteria and within-region R 2 .

Starting from a panel-based fixed-effects distributed lag model estimating the effects of climate on economic growth using the real historical data (as in equation ( 4 )) with ten lags for all climate variables (as shown in Extended Data Fig. 1 ), lags are incrementally removed for one climate variable at a time. The resulting Bayesian and Akaike information criteria are shown in a – e and f – j , respectively, and the within-region R 2 and number of observations in k – o and p – t , respectively. Different rows show the results when removing lags from different climate variables, ordered from top to bottom as annual mean temperature, daily temperature variability, total annual precipitation, the number of wet days and extreme annual precipitation. Information criteria show minima at approximately four lags for precipitation variables and ten to eight for temperature variables, indicating that including these numbers of lags does not lead to overfitting. See Supplementary Table 1 for an assessment using information criteria to determine whether including further climate variables causes overfitting.

Extended Data Fig. 3 Damages in our preferred specification that provides a robust lower bound on the persistence of climate impacts on economic growth versus damages in specifications of pure growth or pure level effects.

Estimates of future damages as shown in Fig. 1 but under the emission scenario RCP8.5 for three separate empirical specifications: in orange our preferred specification, which provides an empirical lower bound on the persistence of climate impacts on economic growth rates while avoiding assumptions of infinite persistence (see main text for further discussion); in purple a specification of ‘pure growth effects’ in which the first difference of climate variables is not taken and no lagged climate variables are included (the baseline specification of ref.  2 ); and in pink a specification of ‘pure level effects’ in which the first difference of climate variables is taken but no lagged terms are included.

Extended Data Fig. 4 Climate changes in different variables as a function of historical interannual variability.

Changes in each climate variable of interest from 1979–2019 to 2035–2065 under the high-emission scenario SSP5-RCP8.5, expressed as a percentage of the historical variability of each measure. Historical variability is estimated as the standard deviation of each detrended climate variable over the period 1979–2019 during which the empirical models were identified (detrending is appropriate because of the inclusion of region-specific linear time trends in the empirical models). See Supplementary Fig. 13 for changes expressed in standard units. Data on national administrative boundaries are obtained from the GADM database version 3.6 and are freely available for academic use ( https://gadm.org/ ).

Extended Data Fig. 5 Contribution of different climate variables to overall committed damages.

a , Climate damages in 2049 when using empirical models that account for all climate variables, changes in annual mean temperature only or changes in both annual mean temperature and one other climate variable (daily temperature variability, total annual precipitation, the number of wet days and extreme daily precipitation, respectively). b , The cumulative marginal effects of an increase in annual mean temperature of 1 °C, at different baseline temperatures, estimated from empirical models including all climate variables or annual mean temperature only. Estimates and uncertainty bars represent the median and 95% confidence intervals obtained from 1,000 block-bootstrap resamples from each of three different empirical models using eight, nine or ten lags of temperature terms.

Extended Data Fig. 6 The difference in committed damages between the upper and lower quartiles of countries when ranked by GDP and cumulative historical emissions.

Quartiles are defined using a population weighting, as are the average committed damages across each quartile group. The violin plots indicate the distribution of differences between quartiles across the two extreme emission scenarios (RCP2.6 and RCP8.5) and the uncertainty sampling procedure outlined in Methods , which accounts for uncertainty arising from the choice of lags in the empirical models, uncertainty in the empirical model parameter estimates, as well as the climate model projections. Bars indicate the median, as well as the 10th and 90th percentiles and upper and lower sixths of the distribution reflecting the very likely and likely ranges following the likelihood classification adopted by the IPCC.

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Kotz, M., Levermann, A. & Wenz, L. The economic commitment of climate change. Nature 628 , 551–557 (2024). https://doi.org/10.1038/s41586-024-07219-0

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• Case Report
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Waardenburg syndrome type 2 with a de novo variant of the SOX10 gene: a case report

• Yuanyuan Li 1 ,
• Yuxue Chen 1 ,
• Yang Sun 3 ,
• Shouxin Li 1 ,
• Lingli Dong 1 ,
• Zongzhe Li 2 , 3 &
• Guifen Shen 1  

BMC Medical Genomics volume  17 , Article number:  104 ( 2024 ) Cite this article

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Waardenburg syndrome type 2 (WS2) has been reported to be a rare hereditary disorder, which is distinguished by vivid blue eyes, varying degrees of hearing impairment, and abnormal pigment deposition in the skin and hair. Variants in the sex-determining region Y-box containing gene 10 ( SOXl0 ) gene may cause congenital deafness and have been demonstrated to be important during the development of WS2.

Complete clinical data of the proband and her family members (her parents and 2 sisters) was collected and physical examinations were performed in the hospital. The laboratory examination including hemoglobin, Coomb’s test, urine protein, ENA, autoimmune hepatitis-related autoantibodies and ultrasonography were all conducted. We obtained the peripheral blood samples from all the participants and performed whole exome sequencing and sanger sequencing validation.

The present study identified a family of 5 members, and only the proband exhibited typical WS2. Beyond the characteristics of WS2, the proband also manifested absence of puberty. The proband and her younger sister manifested systemic lupus erythematosus (SLE). Whole exome sequencing revealed a de novo variant in the SOX10 gene. The variant c.175 C > T was located in exon 2 of the SOX10 gene, which is anticipated to result in early termination of protein translation.

The present study is the first to report a case of both WS2 and SLE, and the present findings may provide a new insight into WS2.

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Introduction

A rare hereditary condition called Waardenburg syndrome (WS) mainly causes following typical symptoms: accumulated pigment in the skin, eyes and hair, various degrees of sensorineural hearing impairment [ 1 ]. There are four subtypes of the typical syndrome (WS1-4) based on their additional symptoms except for the typical symptoms above. The type I of WS is characterized by dystopia canthorum. (WS1, OMIM193500). There are no additional symptoms in WS type 2 (WS2, OMIM 193,510, 600,193, 606,662, 608,890 and 611,584). The type III of WS represents dystopia canthorum and aberrant musculoskeletal function of the upper extremities (WS3, OMIM148820). The type IV of WS is featured with Hirschsprung Disease (WS4, OMIM 277,580, 613,265 and 613,266). Variable phenotype of WS can be observed in both interfamily and intrafamily, suggesting that there is an interplay between genetic modifiers and environmental factors [ 2 ].

WS is genetically heterogeneous. Several genes are involved in the pathogenetic process of WS, such as melanocyte inducing tyrosinase related protein 1, transcription factor (MITF), endothelin (EDN) 3, paired box 3 (PAX3) transcription factor, EDN receptor type B (EDNRB), Snail homolog 2 (SNAI2) and sex-determining region Y-box containing gene 10 (SOX10), accompanied with varying frequencies [ 3 ]. Approximately 15% of WS2 cases are caused by SOX10 variants [ 4 , 5 ]. In 2002, two patients diagnosed with WS and SOX10 variants were reported to exhibit semicircular canals agenesis for the first time [ 6 ].

The SOX10 gene is composed of five exons, and it belongs to the SOX family of transcription factors. The typical gene was also reported to determine the cell fate and to participate in the development of cell lineage, which plays a significant role in the early developmental stages of the peripheral nervous system and neural crest. The SOX10 protein contains a DNA-binding domain named high mobility group (HMG), which is highly conserved and consists of 80 amino acids [ 5 ]. SOX10 was also reported to regulate embryonic development [ 7 ].

The present report describes a 28-year-old female with bilateral hearing damage, pigmentation abnormalities and hypogonadism. Her condition was considered to be a clinical phenotype 2 of WS with a rare SOX10 variant complicated with systemic lupus erythematosus (SLE). The purpose of the study was to report this case for its rarity and to review the relevant literature.

Case description

Complete clinical data of the patient and her family members (her parents and two sisters) were collected, and physical examinations were performed at the Tongji Hospital (1095 Jiefang Avenue, Wuhan, Hubei). We performed experiments according to the Declaration of Helsinki. Consent was obtained from each participant enrolled in our study.

A 28-year-old Chinese woman presented to our hospital for further diagnosis and therapy on June 30, 2020. She had a 6-month history of polyarticular pain, which mainly covered bilateral shoulders, wrist, knee, hip, elbow and proximal interphalangeal joints. Meanwhile, she noted with hair loss, oral ulcer, xerostomia and Raynaud’s phenomenon, but denied morning stiffness, fever, cough, expectoration or chest pain during the course of the disease. Upon physical examination, she was found to have hearing loss of the left ear, irises in blue color and premature grayed hair. Estimated pure-tone audiogram was conducted in our hospital, which indicated bilateral hearing loss (right ear > 100 dB hearing level, left ear > 30 dB hearing level) and left sensorineural hearing loss of the proband (Fig.  1 ). Further investigation of her medical history revealed that she had been diagnosed with primary amenorrhea and exhibited no signs of pubertal sex development. The whole medical history of her family was gathered, and physical examinations were performed on all the family members. Environmental factors were not considered as a possibility.

Multi-frequency stimuli based pure-tone audiogram demonstrated bilateral hearing loss (right ear > 100 dB hearing level, left ear > 30 dB hearing level) and left sensorineural hearing loss of the proband

Through the clinical manifestations above, the woman presented joint, skin and mucous membrane involvement. According to the findings, the patient can be inferred as connective tissue disease (CTD). But her hearing loss, blue irises, premature grayed hair and delayed sex development could not be elucidated by CTD. Then we conducted laboratory examinations for further exploration.

Laboratory examinations, including hemoglobin levels, Coombs test, protein in urine, extractable nuclear antigen(ENA), autoimmune hepatitis-related autoantibodies and ultrasonography, were all conducted in Tongji Hospital (1095 Jiefang Avenue, Wuhan, Hubei). Peripheral blood samples were obtained from all the participants. The expression of adrenocorticotropic hormone (ACTH) was below 5.0 pg/ml. The level of 17α-hydroxyprogesterone was 0.03 nmol/l and of androstenedione was 0.21 nmol/l, which were both below the lower limit of the reference interval (Table SI). Gynecology ultrasonography showed infantile uterus and endometrial cavity fluid. Hemoglobin was moderately reduced and Coombs test was positive. Urinary protein was positive and globulin was slightly elevated. ENA showed antinuclear antibodies (ANA) 1:3,200, which is a nuclear particle type. In addition, anti double-stranded deoxyribonucleic acid (anti-dsDNA), anti ribonucleoprotein (anti-RNP), anti-Smith, anti-Ro/SSA antibodies were positive. Autoimmune hepatitis-related autoantibodies, including anti-mitochondrial M2, anti-GP210 and anti-Ro-52 antibodies, were positive. Erythrocyte sedimentation rate (ESR) (77 mm/h) and IgG (32.08 g/l) were increased. Based on her clinical symptoms and laboratory examination, the patient was diagnosed with SLE. After prednisone (40 mg, qd) and mycophenolate mofetil (0.5 g, bid) standard therapy, the SLE of the patient was kept in a stable condition. Then the prednisone gradually decreased to 7.5 mg (qd) to avoid the side effects. The intervention adherence and tolerability were assessed by testing hemogram, hepatic function, renal function, urine routine once a month and all were kept well. During the course of disease, there existed no adverse and unanticipated events. Timeline of the medical diagnosis and treatment process had been shown in Fig.  2 , 3 . Unexpectedly, her younger sister also had a history of SLE, whereas no other abnormal clinical manifestations were found in her father, her mother and her older sister.

Identification of a de novo variant in the SOX10 gene [transcript ID: NM_006941.3; variant c. 175 C > T (p. Q59X)]. (A) Sanger sequencing of the family. (a) The proband was identified to have the novel variant, while her (b) father, (c) mother and (d and e) two sisters exhibited the wild-type genotype. (B) Family tree of the Waardenburg syndrome type 2 pedigree. The arrow indicates the proband. +/- represents the heterozygous SOX10 -p. Q59X variant. -/- represents wild-type. (C) Affected region of the novel variant. HMG, high mobility group DNA-binding domain; D, dimerization domain; E, conserved domain of SOX10 ; TA, transactivation domain; SOX10, sex-determining region Y-box containing gene 10

Timeline of the medical diagnosis and treatment process

Genetic analysis

Apart from the SLE manifestation, the additional symptoms such as hearing loss of the left ear, irises in blue color and premature grayed hair can not be explained. Then the genetic analyses were performed on our patient as a part of diagnostic procedure.

Firstly, we constructed the deoxyribonucleic acid (DNA) library. The extraction and purification of the genomic DNA in this family were performed with a DNA extraction kit (Tiangen Biotech Co., Ltd.) and Tiangen Automatic Nucleic Acid Extractor (Tiangen Biotech Co., Ltd.). µThe DNA purity was detected with Nanodrop One (NanoDrop Technologies; Thermo Fisher Scientific, Inc.). The absorbance (A)260/280 and A260/230 values were 1.6-2.0. After purification, 150 ng genomic DNA was employed for enzymolysis by fragmentation enzyme. End repair and ‘A-tail’ adding were then conducted. The fragment length was 250–300 bp. Briefly, the following steps included splice ligation, pre-PCR and library purification, library quantification and pooling, concentration, hybrid capture, enrichment and recovery of the target area, post-PCR amplification and purification, library quantification and quality assessment. XGen™ Exome Research Panel v1 (Integrated DNA Technologies, Inc.), HiFi Ready Mix Enzyme (Kapa Biosystems; Roche Diagnostics) and other library construction reagents (Vazyme Biotech Co., Ltd.) were used. The final concentration of the library was evaluated by Qubit 4.0 (Thermo Fisher Scientific, Inc.) and Qubit™ dsDNA HS Assay Kit (concentration > 10 ng/µl). Library fragment length (300–550 bp) was detected using QSeq400 Fragment Analyzer (BIOptic Inc.).

Secondly, the synthetic DNA library was used for whole exome sequencing. µµµWhole exome sequencing was performed using the NovaSeq 6000 platform, NovaSeq 6000 S4 Reagent Kit (Illumina, Inc.) and S4 flowcell with PE150 (read length 150 bp) mode. Point variants and small fragment deletion/insertion variants within 20 bp were detected. The raw BCL data were converted to FASTQ format, and then annotated and analyzed.

Thirdly, we conducted the bioinformatics analysis with the raw data. All data were filtered by fastp software (HaploX Inc.), compared with the hg19/GRCh37 human reference genome by using the bwa software, and corrected by public dbsnp159 database. Only on-target reads were used to call variants using gatk 3.8. Sequencing depth was detected by samtools depth. Statistics of bed file region coverage and 20X sequencing depth was conducted by gatk depth of coverage. Mosdepth 0.2.5 software was used for GC content statistics. The reported mutations were detected using the Clinical Significance for Variants Relative to Phenotypes (ClinVar) ( https://www.ncbi.nlm.nih.gov/clinvar/ ) and human gene mutation database (HGMD) ( http://www.hgmd.cf.ac.uk/ac/search.php ) database. The data that covered < 20-fold and variants whose minimum allele frequency (MAF) was > 0.01% in the Exome Aggregation Consortium database were removed. Next, the noncoding and synonymous variants were removed. Furthermore, the potential pathogenic missense variants were identified by the Polyphen-2 (score > 0.85) ( http://genetics.bwh.harvard.edu/pph2/ ) and sorts intolerant from tolerant (SIFT) (score < 0.05) ( http://sift.jcvi.org ). Point variants were annotated using ANNOVAR software, and further annotation was analyzed with local databases such as HGMD, human phenotype ontology (HPO) and internal carryover rate. The pathogenic variant was referred to the American College of Medical Genetics and Genomics (ACMG) grading criteria [ 4 ].

The whole exome sequencing above was performed for screening possible variants of genes associated with metabolic, endocrine and immune diseases. A total of 1,397 known or novel variations were detected by semiconductor sequencing (Table SII). A heterozygous nonsense variant of SOX10 (Fig.  2 ), c. 175 C > T (p. Q59X), was predicted to be pathogenic according to the ACMG grading criteria. The SOX10 variant has an effect on hearing and pigmentation [ 5 ], which was considered to be the cause of WS2 in the patient. The diagnosis of WS2 was made on the basis of the clinical manifestations above and the international criteria raised by the Waardenburg Consortium [ 7 ]. No other variants related to WS were identified in the patient.

Furthermore, the sanger sequencing validation of the SOX10 gene was then performed with all the relatives of the patient. After enzymatic lysis, the PCR products were labeled with fluorescence signals via the terminal dideoxygenation method for capillary electrophoresis separation [ 6 ]. The forward primer of the SOX10 gene is 5’-GTTGGACTCTTTGCGAGGAC-3’ and the reverse primer is 5’-TGACGTGCGGCTTGCTTTTG-3’. PCR amplifications were performed with an ABI 9700 (Thermo Fisher Scientific, Inc.) as follows: denaturation of 96˚C for 3 min, followed by 30 cycles of denaturation at 96˚C for 15 s, annealing at 56˚C for 15 s and extension at 60˚C for 1 min, and a final extension of 72˚C for 5 min. The purified PCR products with a size of a 391 bp were sequenced by Sanger sequencing. The result showed that SOX10 variant in the patient does not exist in her family members and it was considered to be a de novo variant. In the meantime, no other SOX10 variants were identified in other family members.

Finally, the proband was diagnosed with WS2 containing a rare SOX10 heterozygous variant and she suffered from SLE simultaneously.

The present study reports a Chinese woman diagnosed with WS2, who had a c. 175 C > T (p. Q59X) heterozygous variant in exon 2 of the SOX10 gene. The patient manifested auditory malfunction of both ears, blue-colored irises, premature graying of the hair which are characteristics of WS2. In addition, the patient was absent of pubertal sex development, and exhibited primary amenorrhea, low gonadal hormone, infantile uterus and breast dysplasia. The additional manifestation may be explained by the fact that distinct categories of variants in the SOX10 gene may display various clinical features by affecting different signaling pathways in WS. It has been reported that SOX10 gene variants may result in pubertal delay [ 8 , 9 ]. One case was identified as co-existence of WS2 and Kallmann syndrome associated with SOX10 gene variants [ 10 ]. Meanwhile, in the present study, no other gene variants were associated with the absence of pubertal sex development.

The ACTH level of the patient was under the lower limit of detection. ACTH has been reported to be important in the regulation of melanocytes [ 11 ]. ACTH plays a crucial role in melanocyte differentiation and melanogenesis regulation through the cAMP signaling pathway. It has been suggested that melanogenesis upregulation is associated with cAMP [ 12 ]. In the present study, SOX10 gene variant and low level of ACTH were detected. Thus, it was speculated that SOX10 gene variants may cause melanocyte dysfunction through downregulating the expression of ACTH. However, further research on the pathogenesis of WS is required in the future.

Notably, the patient also presented SLE characteristics, including polyarticular pain, hair loss, oral ulcer, xerostomia and Raynaud’s phenomenon. To date, no cases diagnosed with WS and SLE have been reported. Besides, the family may have a genetic predisposition to SLE. But no studies have been reported the association between the predisposition to SLE and SOX10 gene. The coexistence of WS and SLE may be a coincidence, and it was also speculated that other gene variants may exist in the proband and one of her sisters. As previously reported, there are various genes linked to monogenic lupus [ 13 , 14 ]. Through searching these genes in the proband, gene variants of interferon stimulated gene 15 (ISG15), ribonuclease H2, subunit B (RNASEH2B) and SOS Ras/Rac guanine nucleotide exchange factor 1 (SOS1) were found in the proband, and the dysfunction of these genes may be related to SLE pathogenesis in the proband. Thus, it was speculated that, in a patient with WS, this may combine with any genetic or non-hereditary disease.

The c. 175 C > T (p. Q59X) variant was detected as a heterozygous variant located in the second exon of SOX10 . After analyzing her family members, only the proband contained the variant, indicating that it was a de novo pathogenic variant. The variant of this type was evaluated as pathogenic, and this new variant was absent in HGMD and Clinvar databases. No other WS associated gene (such as MITF, PAX3 or SNAI2) variants were identified. The current study is the first to report the c. 175 C > T (p. Q59X) variant in the SOX10 gene. The truncating heterozygous variant of the SOX10 gene in the present study is a de novo pathogenic variant which caused WS2 associated manifestation in a Chinese woman. Previous studies have shown that ∼  15% of WS2 pathogenesis is related to variants in the SOX10 gene, and several SOX10 gene heterozygous variants have been reported in WS2 in Chinese family [ 15 , 16 , 17 , 18 ]. The present findings expand the knowledge of SOX10 gene variants in WS2.

The SOX10 gene is situated on chromosome 22q 13.1 and contains five exons. Among the five exons, only exons 3, 4 and 5 encode protein. The SOX10 protein consists of 466 amino acids. It has a size of 51 kDa and belongs to the SOX gene family [ 19 ]. SOX10 contains a central DNA-binding domain named high mobility group (HMG) domain, which is a highly conserved and active domain, and a C-terminal transactivation domain [ 20 ]. The HMG domain can specifically identify and bind to the promoters of the target genes, which allows SOX10 to act as a key transcription factor during the process of migration and differentiation of neural crest cell, including melanocytes, olfactory ensheathing cells, intestinal ganglion cells, and numerous sensory and autonomic ganglion cells [ 21 , 22 , 23 ]. The transactivation domain of SOX10 activates the transcription of the MITF, tyrosinase and EDNRB genes [ 24 ]. The target genes of SOX10 (including MITF, tyrosinase and EDNRB) participate in melanin synthesis [ 21 , 22 ]. SOXl0 plays a crucial role in the pathogenesis of WS, and SOXl0 variants may lead to WS2 and WS4, which can result in hearing impairment and pigmentary abnormalities of the hair, iris and skin [ 15 ]. In addition, variants in SOX10 may cause other neural crest-related diseases, including central demyelinating leukodystrophy, peripheral demyelinating neuropathy and Hirschsprung disease [ 25 , 26 ].

The present study identified a de novo variant in the SOX10 gene, which provides a new perspective into the mechanism of WS and contributes to updating the HGMD and Clinvar databases. Moreover, the current study is the first to report a case of WS2 complicated with SLE, and the present findings may lay a vital foundation for non-invasive prenatal genetic diagnosis and genetic counseling. Furthermore, the co-occurrence of WS2 and SLE in the current case broadens the recognition that a patient with WS may combine any genetic or non-hereditary disease, which may contribute to the field of disease diagnosis in the future. The association between WS2 and SLE should be further explored. In addition, targeted gene therapy should be emphasized for SOX10 and other genes in patients with WS2. Moreover, it is necessary to pay particular attention to the sexual development of patients with WS2 with SOX10 variants during adolescence.

Data availability

All data generated or analyzed during the present study are included in this published article.

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GS, ZL and SL participated in the conception and supervision of the project. GS, LD and YL were involved in the design of the study. YL and YC conducted the experiments. YL and YC saw and verified all the raw data. YL and YS analyzed the results. YL drafted the manuscript. All authors approved the final version of the manuscript.

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Li, Y., Chen, Y., Sun, Y. et al. Waardenburg syndrome type 2 with a de novo variant of the SOX10 gene: a case report. BMC Med Genomics 17 , 104 (2024). https://doi.org/10.1186/s12920-024-01877-9

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