The Use of Causal Language in Case Reports and Case Series Reporting Ischemic Stroke Following Cervical Manual Therapy: A Qualitative Study Protocol
Nora Bakaa, Melissa Atkinson-Graham, Joshua Plener, Pierre Côté, Carol Cancelliere, L. Rachid Salmi, Jan Hartvigsen, J. David Cassidy, Chiara Arienti, Marco Campello, Sheilah Hogg-Johnson, Fred Johansson, Heather M. Shearer, Eva Skillgate, Jessica J. Wong, Cecilie K. Øverås, Iben Axén, Manav V. Vyas, Cesar A. Hincapié, Silvano MiorObjective
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.