Clinical responsibilities and teaching can leave little time for traditional research. However, clinical practice can actually be a goldmine for meaningful scholarly communication! Choosing the right study design allows you to contribute to evidence-based optometry even though your time is limited.
Medical literature typically categorizes study designs into a hierarchy of evidence, moving from descriptive observations to highly structured experimental designs (Sackett et al., 1996).
The Clinical Study Matrix: Feasibility vs. Rigor
Below is a breakdown of clinical study types, ranked from the most time-efficient (e.g., documenting an unusual case in clinic) to the most time-intensive (e.g., executing a randomized controlled trial).
Study Design | What It Does | Clinical Example | Feasibility for Busy Clinicians 🔴🟡🟢 |
Case Report / Case Series | Describes an unusual presentation or novel treatment outcome in 1 to 10 patients. | Documenting a paradoxical corneal response to a new orthokeratology lens design. | 🟢 Can be completed in weeks using existing chart data. |
Cross-Sectional Study | Analyzes data collected from a population at a single point in time (e.g., surveys or chart audits). | Evaluating the prevalence of dry eye symptoms among university students using a digital screen survey. | 🟢 Ideal for utilizing clinic populations or student/resident assistance. |
Case-Control Study | Retrospectively compares patients with a condition ("cases") to those without ("controls") to find risk factors. | Comparing historical charts of patients who developed microbial keratitis vs. successful contact lens wearers. | 🟡 Requires careful matching of patient records but no active follow-up. |
Cohort Study | Follows a group over time to see how an exposure or risk factor affects an outcome. | Tracking the 3-year progression of myopia in axial length between children wearing soft multifocal lenses vs. spectacles. | 🟡 Requires long-term tracking; high risk of patient drop-out. |
Randomized Controlled Trial (RCT) | Prospectively and randomly assigns patients to an experimental group or a control group. | Blinding and randomizing patients to evaluate a new preservative-free glaucoma drop vs. a standard drop. | 🔴 Highly resource-intensive; requires extensive funding and strict ethical oversight. |
Descriptive Research: Case Reports
These are non-analytic studies that lack a comparison group. They are crucial for flagging rare adverse drug events, unusual ocular pathologies, or innovative clinical techniques (AAP, 2022).
- Why it fits your schedule: You are already seeing the patients. Documenting a unique case requires minimal administrative overhead compared to prospective trials.
- Limitations: Cannot establish definitive cause-and-effect relationships due to small sample sizes and potential selection bias.
- IMPORTANT: Case reports should always follow CARE guidelines.
Learn more about case reports
Observational Analytic Research: Leveraging Compulink
In observational studies, the clinician does not alter the care provided, but systematically records and analyzes the data (Oxford CEBM, 2023).
These offer a "snapshot" of a population. They measure the exposure and the outcome at the exact same time.
- Why it fits your schedule: Perfect for clinical surveys or "one-and-done" chart audits. You can easily integrate data collection into a standard student clinic rotation.
Learn more about cross-sectional studies
These are retrospective. You identify the clinical outcome first (e.g., patients with advanced glaucoma damage) and look backward in time to identify potential risk factors (e.g., a history of sleep apnea).
- Why it fits your schedule: Highly efficient for studying rare conditions because you do not have to wait for a disease to develop (AAP, 2022).
Learn more about case control studies
These look forward (prospective) or leverage structured history (retrospective) to track a group over time. They are excellent for establishing chronological associations between an exposure and an ocular disease.
- Why it fits your schedule: Retrospective cohort studies (using existing EHR data over the last five years) are highly feasible. Prospective cohorts are rarely feasible for for busy clinicians due to the time commitment.
Learn more about cohort studies
Experimental Clinical Research: The Gold Standard
Randomized Controlled Trials (RCTs)
RCTs sit near the peak of the evidence pyramid because random assignment minimizes bias and confounding variables, allowing researchers to confidently establish causality (Francis, 2025).
- Why it's tough for busy faculty: RCTs require dedicated research coordinators, strict adherence to institutional protocols, and significant institutional funding.
- Recommendation: Instead of launching an independent RCT, look for opportunities to serve as a co-investigator or clinical site investigator for multi-center trials managed by industry or larger institutions.
- If you’re interested in conducting an RCT, please refer to NECO’s internal research study guidelines (NECO Portal login required).
Learn more about RCTs
Publishing clinical studies
This guide was prepared by NECO librarians with the assistance of Google Gemini 3, Anthropic Claude 4.5 Sonnet, OpenAI GPT 5 Mini, and Consensus, as well as in consultation with NECO’s research and clinical leadership.
