10 juli 2026

763. The Use of Causal Language in Case Reports and Case Series Reporting Ischemic Stroke Following Cervical Manual Therapy: A Qualitative Study Protocol

Bakaa N, Atkinson-Graham M, Plener J, Côté P, Cancelliere C, Salmi LR, Hartvigsen J, Cassidy JD, Arienti C, Campello M, Hogg-Johnson S, Johansson F, Shearer HM, Skillgate E, Wong JJ, Øverås CK, Axén I, Vyas MV, Hincapié CA, Mior S.
International Journal of Qualitative Methods. 2026;25:1-11

Abstract

Objective:
This study aims to investigate how authors attribute causality in case reports and case series describing ischaemic stroke following cervical manual therapy.

Methods:
This qualitative, document-based study is nested within a larger epidemiological investigation evaluating the association between cervical manual therapy and ischaemic stroke (PROSPERO ID: CRD42024602659). Eligible case reports and case series will be identified through a systematic review of biomedical databases. A software-assisted qualitative content analysis will be undertaken in MAXQDA, combining deductive coding, guided by counterfactual theory and the concept of hypothesis generation, with inductive coding to capture linguistic patterns.

Conclusion:
This research protocol presents a novel approach to examining how causality is attributed in case reports and case series, addressing the relationship between ischemic stroke following cervical manual therapy for headaches or neck pain. The anticipated findings have implications for improving the clarity and responsibility of scientific communication and informing the interpretive boundaries and appropriate use of descriptive research designs in clinical and policy contexts.

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