case study report architecture

How to Present Architectural Case Studies like a Pro

Design is arbitrary. Design is subjective , and there is just no way of getting around the fact, and architecture in many ways is the art of convincing people that one’s design was the right move and one of the ways you can convince people is through case studies. There is no way to avoid that reality, and case studies are one of the methods to persuade others that your design choices are sound. In many respects, architecture is the art of persuasion. Architectural case studies act as a shield that, when properly presented, can be a very effective way for one to defend your design viewpoints , especially if anyone chooses a project that has already been successful and was completed by a well-known architect. This can help one establish a strong foundation for design strategies because it can be much more difficult to critique something that has already been shown to be effective.

Architectural case studies should be presented in an educational, interesting way, and can build a strong case for your project. While performing a case study, one could learn many different things. Still, when giving a presentation, one must highlight the elements one will use in their design, diagram the visuals, and remember that visual continuity is important.

“Every great design begins with an even better story.”

Which case study to choose?

The first step is to determine the type of structure to be developed. Consider whether your project is within the categories of a residential project , a public building, a private mixed-use project, etc. By doing so, you may focus your search and locate projects with similar outlines. This does not imply that a structure that is unconnected at all will not be useful. A building’s components may be more significant than its function.

For instance, Correa stayed away from high-rise housing options, emphasizing low-rise ones that, when combined with amenities and common areas, highlighted the human scale and fostered a feeling of community. This is how case studies help us to view the projects with a certain inspiration to be used in our projects.

The next important point is to confirm that the case study and your project have parallel elements. This may be the atmosphere or climate , anything analogous that you can connect to. You can always decide to include some in your project if there aren’t any. Remember that they are there to help you and frequently have more expertise about various structures. Better still, if your brief mentions any interesting buildings, you may always start there.

What points are to be kept in mind?

• Attractive elements-

One feature of the building may appeal more than any other aspect. To make a building into something much more fascinating , for instance, the usage of a specific sort of beam or steel structure, or even the materials that were utilized for the design, might be crucial. Focus on the space’s fantastic structural features if their intended use is irrelevant, and you can still make use of them.

• Balancing form and function-

Extreme aesthetic aspects in some structures may be more challenging to plan and implement. Utilizing your own smaller test models, ascertain how these shapes were developed and then apply them to your system. The purpose of a architectural case studies is to improve any project. Without using the research , it is pointless to do it.

• Area requirements-

Study the building’s utilization in further detail, including how each room is used. Depending on a project or brief and what precisely one wants to learn from the case study, it can be as detailed as one likes. Try making a physical visit if it’s feasible, and write as many notes as possible on the experience. Consider the interior areas and their functions thoroughly.

• Technicalities-

Concentrate on the case study’s technical components if necessary. The HVAC or other concealed systems may be of interest if the concerned project is geared toward domestic areas.

Last but not least, be sure to provide several important case study photographs . Instead of choosing basic front elevations, examine closer and pay attention to details.

What are the best ways to present?

After conducting a tonne of research and compiling this information, one must figure out how to incorporate it into a portfolio.

• Site analysis-

The most effective way to communicate your results is via a site analysis . This type of page might be a straightforward construction diagram with comments outlining the noteworthy elements you discovered and why they are significant.

• Images and graphics –

No matter how big your page size is, don’t overstuff it. Choose four to five main photos that may be expanded on later. When printing them, make sure the quality is good. It should be required to use text.

Always look for quality over quantity.

• Models and Iterations-

Put these in if you decide to conduct any experiments using physical or digital models . It demonstrates engagement with the undertaking and effort in making decisions on any building. These might be of great use when creating subsequent sketches.

•       SWOT Analysis-

Analyzing the strength, weaknesses, and opportunities, threats of the concerned project can be of great help. An opportunities and limitations diagram can be created for architectural case studies and site analyses. Although it’s not necessary, one may undoubtedly construct one if it’s essential.

• Crisp and clear data –

The best way is to use pictures or diagrams to accompany all the data you have acquired, including any historical details. Try to limit the amount of text on the page to what is necessary to convey the main ideas.

In addition to this, bear in mind that using the right color schemes, grids, tags, and human figures, as well as their surroundings, adds valuable information and serves as the cherry on top.

References-

• https://toscaleblog.co.uk/analysing-architecture-case-studies-for-beginners/
• https://www.youtube.com/watch?v=n0c_BzpLUYM&t=19s&ab_channel=ArchiHacks

A place to visit; A girl who obsesses with everything enthralling. You will often find her behind a bookshelf. She is fascinated by the stories around her, weaving new adventures, and journeys through words. She is curious, observant and all the bright colors in one. She is a tender heart and smells of cider, written words, and paintbrush water.

Luxor Temple, Egypt

Most Colorful Cities in the World

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Architecture Student Chronicles

How to conduct a Case Study?

When students begin studying  Architecture at a University, the first thing that they are supposed to become excellent at, is doing a documentation or a case study . It could be a case study of a small village, town, a villa, a bus-stop, or a high-rise commercial or residential building. A case study is an in-depth investigation of a single individual, group, incident, or community. Other ways include experiments, surveys , or analysis of archival information

What is the purpose of conducting a Case Study?

As the term Case Study suggests, it is the study of a particular case that is similar to your topic of design project. Doing a case study will help you understand the various aspects that you have to consider while designing.

Literature Case study

Before you start with your live case studies, first of all do a complete literature case study. Literature case study consists of reading everything you can find on the subject. You can refer books in a library, use Google to look up research papers, check out Standard Code books and statutory laws or from technical journals.

A literature case study would give you a vague idea about your topic. There will be various questions arising in your mind after you are done with your literature case study. To find the answers to those questions, you will have to go for minimum two live case studies….

Always possibly go for more than two different case studies, because a comparative case study of two or more different cases is very important and helpful.

• While you are doing your first case study, say a Villa, go for a smaller Villa first so that you can figure out the basic minimum requirements.
• In your second case study, go for an extremely lavish Villa so that you are aware of the maximum requirements you could give.

(Being able to provide maximum or minimum requirements in your design is very important)

If there are some requirements that you haven’t come across while doing your case studies but you went through it while you were doing a literature case study, then try implementing those requirements  in your design.

Eleven most important things to analyze in any Case Study

• Environment and micro-climate Analyzing the surrounding environment and the micro-climate of that place will help understand the reason of the orientation of the structure, the kind of roof chosen and the materials used in its construction.
• User behavior and requirements Studying the functioning of a particular place, say a Hospital, is very important; without which you will not be able to figure out the requirements and the area that should be allotted for each of the requirements.Talking to people working at that place (Hospital), will help you figure out if the requirements that are provided are adequate and he area that is allotted is sufficient for its efficient working.
• Utility and space enhancement Study of Utilitarian facilities of a particular case is also important. Various measures taken to enhance a particular space should be analyzed.
• Form and Function Analyzing the reason behind the form of that particular building…and how it merges with the surrounding environment. Form and Function go hand in hand. The form of the building should be able to convey the function of the building. A lot of Architects say “Form follows Function”.As an example, an institutional building should not end up looking like a museum or a disco.Some other Architects might disagree with that philosophy. They’d say that the function of a structure keeps changing but changing the form of the building everytime its function changes is not possible. They say, Adopt a “Universal Design Scheme”.
• Horizontal and vertical circulation Horizontal circulation consists of elements such as the corridors and lobbies. Vertical circulation includes elevators, staircases, ramps etc. The efficiency of the placement of these services should be analyzed.
• Site Planning and Landscape detailing Refer to the Article on the blog “ A Guide to Site Planning “, which deals with different aspects considered in site planning in greater detail.
• Structural details such as Column and Beam Design, Steel  and Composite structures Understanding and analyzing the structural details is also important. For example, large span structures such as Auditoriums use trusses or heavy I-section steel beams and sometimes shell-roofing that involve construction of Ring beams whereas in small span structures, RCC construction is used.
• Building Services such as Fire Alarm system, HVAC, Water supply systems The working of Fire Alarm system, HVAC and Water supply systems should be examined and their space requirements are to be analyzed.
• Design detailing considering the Barrier-free environment Implementation of the Barrier-free architecture for comfortable access to disabled people. Most public buildings have mandatory accessibility systems for the disabled. Check out Guidelines to the Disability Standards for Access to Premises 200X. (Australian law)
• Socio-economic profile of user group It might also be important to find out the socio-economic profile of the people using the services so as to determine their requirements and available resources.
• Parking details and standards Measure the allotted parking area on site, say for ten cars, then calculate the average area for each car and compare it with the areas specified in TSS (Time Savers Standards).

Conducting a case study is hard work. Sometimes, it is so small, it could be done in days, but on other occasions, it takes weeks to document and compile all the data. It involves going on-site, meeting and taking to people, lots of traveling, plenty of photography, and some fun. It is the most important of assignments you might get as an architectural students.

This is where you learn from reality, actual stuff, as opposed to only theoretical knowledge. When I was learning law I took every chance I could get to learn from people actually doing the work I was aiming for, yes I did “donate” many hours to Winters & Yonker, P.A. , but in the end is was worth every minute. Looking at places first hand  and documenting information would give you many insights and ideas and let you peek into the minds of professional architects and designers who have used years of experience and improvisation to design and create incredible structures.

Case studies of some of the famous Structures mentioned below:

 SPA – Delhi

VNIT – Nagpur

Thiagaraj Convention Center

TKM College of Engineering (Chennai)

42 thoughts on “How to conduct a Case Study?”

We want to design an oldage home how u can help

You live in Delhi and I am in Hyderabad, so I might not be of much help, unless you want my father (Architect Javed – http://www.architectjaved.com/ ) to design it for you.

If you want more info on Old age homes, see http://architecture-student.com/design-guide/guide-to-designing-old-age-homes/

The hardest part is looking for related literature especially when your research topic is new. It may be that difficult but it is surely unique when done and published.

I’m an attorney and when studying law we spent the bulk of the time reading what is called caselaw which is existing decisions that forms our law. We are to find cases that support our clients’ fact scenario so that the decision is our clients’ favour.

The parallel with architecture is uncanny as architects use existing structures and environments to form the basis for a new project. As the saying goes, “no need to reinvent the wheel” but it’s good to evolve from existing structures. Likewise, the law evolves.

Case Study is itself a very necessary work to be done before appearing to anything to be done. It’s just a sample report before appearing for any cases to get it solved properly.

A good blog to read on and to be shared amongst all…..

For me, Case Study is really important on anything you are planning in order to have a well planned and a successful outcome. Doing a Case Study on anything gives you an idea for the pro’s and con’s of that. I’m glad there’s such an article like this!

Case studies are a great way to plan lots of things, not just architectural projects. It’s almost like doing the work without actually doing the work, so you can identify sticking points, potential problems and lots more.

thank you that really helped….!! im a first year b.arch student….

Hello Nanda, We are glad our site has been of help to you. Do keep visiting. We wish you all the best for your future!

will do 🙂 thanku 🙂

it’s really helpful!! thx a lot!

i am beginning my thesis in B. arch. n so m requiring a hypothetical site of about 3 acres here in india with the climate warm and humid. topic is performing arts centre in kerala. how do i find and fix a hypothetical site?

Hello Resbi, The best way to find an appropriate site for your project could be done by using Google Earth.

i would like to know the steps and what case studies to do about for a multispeciality hospital

As im in 2nd year of b.arch

I have not much studed about much detailed

Like casestudy,site analysis’

It will help me

Thanks u again

U can see our 1st year architecture 1st month exibition video on youtube

hi !!!I’m a 1st year b.arch and v hav 2 do a case study on an architect’s firm . cud u tell me wat all i shud include in my case study???v hav to do a case study on a bungalow also…

Hello Joan,

The following links will be of help to you.

Guide for conducting a casestudy for a villa

Also check out: Cafeteria Design

i am a first year b.arch student..i have got a case study to do..can u please guide me by teling how many sheets should i present..please guide me..as soon as posible..ur site helpd me to knw how to do case study but i also want to know how many sheets should it include..please guide me..

tanx for this good work.pls do continue.

Number of sheets doesn’t matter until you pin down your inferences correctly …… for a first year student i guess a max of 1 or 2 A1 sheets or a ppt of less than 20 slides should be enough in terms of quantity …. make sure you put the point across 🙂 🙂

This was really helpful. Thank you very much. Just about to go for a case study on 2 schools.

What r all things I should see for bedroom attached bathroom casestudy.

Thank you for some other wonderful article. The place else could anyone get that type of information in such an ideal manner of writing? I’ve a presentation next week, and I am on the search for such information.

this really helped alot Thankyou

love your articles ,wld love to b part of this, was just surfing the net and found this…….good work to u guys

Hey, this really helped I’m goin for a case study on resorts tmrw Would appreciate any pointers to observe there thanq ????

hello,i am second year b.arch student,i have to do case study on luxury primary school . cud you please tell me what all should i include in my case study ???and also case study for the kids school…………

For a project like that, you should visit a minimum of two schools. One would be a high profile school and the other one could be a private low budget school or a government school. After you casestudies you will be able to draw comparisons between the two and that should help you come up with your list of requirements. let me know if you have any other questions.

I am doing by 3rd year b arch n this time our project is based on housing for artist Wht all shld I keep in mind while designing for artist n der family member who are non artist

Hello Monisha, I recommend you to read this article: http://architecture-student.com/case-studies/design-of-an-artist%E2%80%99s-house-guide-for-conducting-a-casestudy-of-a-villa/

Nice bolg. Thank you. I am barch student. I would like to know how to do comparison study of any two building. Now I have done with case study of a gallery (ngma Bangalore). I have done sub case study as well as literature study. But I want to know how exactly should I do comparitive study. More than write up comparison, How well can I present it

I am doing thesis on Orphan children and oldage home combining both generations together so as to create marvelous socially conceptual design. Help me with bestest case study from which I can learn alot to create spaces for both.

I am final year in srm rampuram school od architecture and doing thesis on township. So could anyone help with sum reference for case study and literature study as soon as possible

Hello Revathy,

When you say township… what kind of township. Give us some description of your thesis project so that we could give suggestions as to how you could proceed.

thanks a lot it is great information has answered some of my questions

hello.i have taken up the topic EMBASSY(any country) Design for my final year thesis. i was wondering if you could help me out with the plans for casestudies,since i hear it will be quite a problem with all the security.

It is not an excellent topic for design. You should have chosen something that would let you explore your ideas. Embassy building would look like a commercial block…nothing interesting… this is not something people havent seen. I do not think you will get permission for a livecasestudy of any embassy. No one would let you in. So if you still have time, i would suggest you choose a more design oriented topic.

hey i am doing thesis on low cost building materials and technology.i wanna do commercial project on this topic. can you suggest me project name or case study on this topic.

I have taken service apartment complex for tourist as my final year thesis. Help me to find the best case study for thesis.

Hello. Im studying b.arch 4th year. Im supposed to do a thesis case study, on Automobile industry i.e a car manufacturing plant. Can you please help me regarding this, as what all i should include and what steps i need to follow to complete my case study. Please reply me asap. Thank you.

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These timber case studies demonstrate how the material can be used for inside and out

• Mass Timber
• Trading Notes
• Outdoor Spaces
• Reuse + Renewal
• Architecture
• Development
• Preservation
• Sustainability
• Transportation
• International

Tenacious Timber

The latest timber products demonstrate how advanced applications of this age-old material have become in recent years. Reengineered and reimagined, sustainably sourced wood can be harnessed in everything from interior finishes to skyscraper structures. The following selection of durable flooring, sophisticated cladding, and sturdy framing solutions highlights the dynamism of North America’s expanding timber industry. Innovative fasteners and cutting-edge software specifically for timber construction help the AEC design community find new uses for this material. The following timber case studies show how these materials and tools can be masterfully implemented.

Karsh Alumni and Visitors Center

Architect: Centerbrook Architects Location: Durham, North Carolina

Landscape architect: Stephen Stimson Associates Landscape Architects Structural engineer: LHC Structural Engineers MEP/FP engineer: Dewberry Civil engineer: HDR Contractor: LeChase Construction Services Lighting design: Cline Bettridge Bernstein Lighting Design

The Karsh Alumni and Visitors Center welcomes people to the Duke University campus with a series of warmly lit courts and pavilions that combine new construction techniques with historical motifs. The 48,000-square-foot complex includes various social spaces that comfortably host both large and small groups, including a two-story alumni association office, a meeting pavilion, and the newly renovated Forlines House, originally designed by Horace Trumbauer, the architect of much of Duke’s campus.

Adjacent to the neo-Gothic West Campus, the visitors center reflects Duke’s identity as a “university in the forest.” Exposed wood elements featured across the buildings and a main courtyard complement the locally quarried Duke stone and bird-friendly glass paneling that make up the central pavilion. – Keren Dillard

EF Education First

Designer: Gensler Location: Denver

Acoustical consultant: K2 Audio Client and collaborator: EF Architecture & Design Studio General contractor: Rand Construction MEP engineer: Salas O’Brien Structural engineer: KL&A CLT/Timber supplier: Nordic Structures

EF Education First, an international school that specializes in experiential learning, looked to Gensler to create a sustainable office in Denver that would embody the company’s ethos and the spirit of Colorado. The resulting CLT structure echoes the look and feel of the neighboring Rocky Mountains, connecting visitors to the great outdoors through natural colors, textures, and materials.

High ceilings, natural light, and exposed timber beams create airy interiors. The biophilic color palette of the spaces—including soft tones and warm woods—mimics the surrounding landscape. A minimal reception desk, molded out of rammed earth from local soil, nods to Colorado’s red rock canyons, and a stairway with rows of floor-to-ceiling pine boards conjures the feeling of hiking through a forest. Adjacent lounges and workspaces are flanked by movable timber walls that allow team members to alter spaces depending on their needs. – Ali Oriaku

Hotel Magdalena

Architect: Lake | Flato Architects Location: Austin, Texas

Client and interior designer: Bunkhouse Group, Tenaya Hills Timber superstructure structural engineer: StructureCraft Base building steel and concrete structural engineer: Architectural Engineers Collaborative MEP engineer: Integral Group Landscape architect: Ten Eyck Landscape Architects General contractor: MYCON General Contractors Dowel-laminated timber panels: StructureCraft Windows and doors: Sierra Pacific Aluminum Clad Wood Windows/Doors, La Cantina Aluminum Doors, EFCO 5600 Slimline Aluminum Storefront

Hotel Magdalena is the first mass timber boutique hotel in North America. This 100,000-square-foot oasis honors the former site of the Austin Terrace Motel in Austin, Texas. Hotel Magdalena welcomes its visitors with a two-way gridded porte-cochère and hosts a series of vibrant common exterior spaces, outdoor walkways, shaded porches, and lushly planted terraces that recall lake houses and natural artesian springs found in the Texas Hill Country. The exposed wood in every space provides a warm and textured ambiance that ensures the timber structural components are an integral part of the hotel experience. This is also meant to spur daily conversations about sustainable construction and building practices. – Keren Dillard

NW 28th Brewery and Office Space

Firm: ZGF Location: Portland, Oregon

Developer: OSB2LAN MGM Fire protection engineer: Wyatt Fire Protection General contractor: Centrex Construction Structural engineer: KPFF Consulting Engineers Timber installer: Carpentry Plus Timber suppliers: DR Johnson Lumber, Nakamoto Forestry

A former warehouse in Northwest Portland, Oregon, has been transformed into the home of Great Notion Brewing, whose state-of-the-art taproom, coffee shop, and office space enliven the industrial neighborhood. Designed by ZGF, the building uses modern timber technology and locally harvested materials to showcase the region’s manufacturing roots.

The repurposed taproom, constructed of cross-laminated timber (CLT) and clad in naturally weathering Cor-ten steel panels, is connected to a spacious lobby made of yakisugi Japanese burnt timber. The raw CLT panels contrast with the black charred wood entry to create a bright, warm, and inviting space where patrons can drink Great Notion’s beers and marvel at the massive metal fermentation tanks that sit behind a nearby glass wall. – Ali Oriaku

Architect: Perkins&Will Location: Soo Valley, British Columbia

Client: Delta Land Development Electrical engineer: Rainbow Electric Energy consultants: Gencell, VREC Fire protection engineer: Viking Fire Protection General contractor: Durfeld Builders Glazing: Blackcomb Glass HVAC: Custom Air Structural engineer: StructureCraft Timber supplier: Structurelam Welder: OpenWide Welding Windows: Optiwin

Overlooking the Soo Valley in British Columbia’s Coast Mountains, SoLo, designed by Perkins&Will, is a Passive House–certified home made almost entirely of Douglas fir. Perkins&Will transformed the remote site into a luxury off-grid retreat that produces more energy than it consumes, with combustion and fossil fuels removed from its daily operations.

The project’s strategically limited material palette reduces the home’s embodied carbon footprint. The modular, prefabricated timber panels were trucked to the site and lifted into place by crane, reducing waste and construction time. Because of the valley’s harsh climate, the enclosure is composed of two layers of timber, with a heavy outer frame serving as a weather shield, and an insulated inner layer designed to contain heat. A glass curtain wall found at the rear of the home lets guests take in a view of the valley. – Ali Oriaku

Kendeda Building for Innovative Sustainable Design

Design architect: The Miller Hull Partnership Collaborating architect and prime architect: Lord Aeck Sargent Location: Atlanta

Timber installer/framer: Universal Timber Structures Timber supplier: Unadilla Laminated Products Salvaged lumber finishes supplier: Raydeo Enterprises General contractor: Skanska Landscape architect: Andropogon Design engineer: PAE Electrical engineer: Newcomb & Boyd Civil engineer: Long Engineering Structural engineer: Uzun + Case Graywater systems water consultant: Biohabitats

The Kendeda Building for Innovative Sustainable Design is the first mass timber building on the Georgia Institute of Technology’s campus, and its 46,848 square feet of programmed space makes it the largest higher education building to achieve Living Building certification. It uses FSC-certified, responsibly harvested timber for its decking, benches, tables, and counters. According to the architects, that has saved 33 percent more carbon from being released than if the wood had come from a non–sustainably sourced supplier. The architects also said that the wood in the project has sequestered more than 100,00 kilograms of carbon dioxide. The Kendeda Building embodies a bold, values-driven vision that promotes sustainable construction and design methods. – Keren Dillard

Reimagine Architect references fur trade–era cabins for The Lodge at Metís Crossing

Greg Esparza pushes the ecological envelope with Cross Cabin in Austin

In Atlanta, 619 Ponce by Handel Architects and Jamestown is Georgia’s first mass timber building to use locally sourced timber

Free Site Analysis Checklist

Every design project begins with site analysis … start it with confidence for free!

Architecture Precedent Study Guide

• Updated: December 31, 2023

Architecture is not just about designing buildings; it’s about creating spaces that work well and look great. One way architects do this is by learning from the buildings that came before. In this article, we’ll explore how architects study old buildings, why it’s important, and how it helps make better designs.

Think of it as learning from the past to make the future better. We’ll see what these studies are, why they matter, and how architects do them. We’ll also look at some examples and the challenges that can come up. Plus, we’ll share where architects can find information to do these studies well.

So, let’s jump into the world of architectural precedent studies to discover why they’re a big deal in the world of architecture.

What is an architecture precedent study?

According to the Merriam Webster dictionary a ‘ precedent ‘ can be defined as “ something done or said that may serve as an example or rule to authorize or justify a subsequent act of the same or an analogous kind”, and a ‘ study ’ as “ a state of contemplation ”

So when defining the term and meaning of a ‘precedent study’, it can be classed as the sourcing and contemplation, of related and relative, past and present influences, that aim to serve and provide inspiration and help with the justification of an idea.

These examples often come in the form of visual aides, and form vital parts of a projects foundation and overall concept, with many projects finding their initial starting points from one singular precedent.

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What is the difference between a case study and a precedent study?

Case studies and precedent studies are related but have distinct purposes and focuses within the fields they are commonly used.

Case Study:

• General Overview: A case study is a detailed examination and analysis of a specific project, event, situation, or instance. It can be applied to various disciplines, including business, medicine, law, and architecture.
• Focus: Case studies typically center around a single, unique occurrence or project. They aim to provide an in-depth understanding of the particular subject under investigation.
• Purpose: The primary purpose of a case study is to gain insight, gather information, and draw lessons from a specific instance. It often involves a detailed narrative, describing what happened, why it happened, and the outcomes.
• Application: Case studies are used to examine real-world scenarios and provide a comprehensive examination of various factors, including context, processes, and results.
• Examples: In architecture, a case study might focus on a particular building, discussing its design, construction process, challenges faced, and its impact on the surrounding environment.

Precedent Study:

• General Overview: A precedent study is a research and learning method commonly used in architecture and design. It involves the investigation of existing buildings, designs, or projects that share similarities with the one being planned.
• Focus: Precedent studies concentrate on studying existing examples that are relevant or analogous to the design problem at hand. The emphasis is on extracting design principles, concepts, and ideas from these precedents.
• Purpose: The primary purpose of a precedent study is to inform and inspire the design process by examining successful or innovative solutions in similar contexts. It provides a source of reference and a foundation for creative problem-solving.
• Application: Precedent studies help architects and designers understand how others have addressed similar challenges, integrated design elements, and achieved desired outcomes. They guide the design process by offering valuable insights and ideas.
• Examples: In architecture, a precedent study might involve researching and analyzing buildings with similar functions, climate conditions, or cultural contexts to inform the design of a new project. It focuses on design strategies, materials, and spatial arrangements rather than documenting a specific project’s history.

In summary, while both case studies and precedent studies involve in-depth examinations, case studies typically delve into a single, specific occurrence or project, aiming to understand it comprehensively. Precedent studies, on the other hand, focus on extracting design inspiration and lessons from existing examples to inform the creative process in architecture and design.

How are precedent studies used when designing buildings?

Precedent studies (similar to case studies ) form the backbone of a projects creation and remain just as relevant at its inception as they do during its construction, aiding with:

Inspiration – From seeking initial design inspiration, through to sourcing the right material finishes, precedent studies provide an excellent resource and visual library of thought provoking media.

Design concept generation – Studying past and present examples of work in and around the arts and architecture, helps to develop an understanding of the thought process that lead to a projects creation and its underlining driving force, ’ the design concept ’.

Sometimes directly, but most likely indirectly, this will inspire and open up alternative lines of thinking towards your own concept development , adding depth and justification to your design process .

Justification – No matter what stage you are in your learning, or what level of creative thinker you, we all need justification that our ideas and approaches will ultimately work and be successful.

This is particularly important for architecture, where not only must it be physically possible to build, it in most instances must also outlast its creators.

Finding examples of similar design and construction approaches, provides us as designers with a degree of confidence in knowing that we are pursuing the right direction.

Explanation and Communication – Precedent studies can be used to explain and communicate the vision of a project, for example from how a building might house its occupants, through to material choices and its finished appearance.

Peers, tutors, and clients have confidence in what they can understand, and if you can provide examples of what already exists, then it becomes far more difficult to misinterpret the designers vision.

How to find precedent studies

As listed below in the resources section, there are a few key places to find good precedents, however ultimately its just research, and relevant precedents can and will come from anywhere, and will always be bespoke to a particular project. They are rarely carried over from one to another.

For architecture in particular, you should focus on breaking the project and brief down into segments and create sub categories for your research. This way each category will influence the next and help to form an overall vision.

Trying to find a singular precedent to cover everything is extremely difficult, and will only lead to frustration.

These categories may include:

• Building use
• Building occupants
• Type of site
• Building location
• Building plan
• Building elevation
• Building section
• Building typography
• Building type
• Building size
• Sustainable strategies
• Construction strategies

Choosing an appropriate precedent study is important, as it allows you to derive relevant lessons and insights for your current project or situation. Here are some steps to consider when choosing a precedent study:

• Identify Your Purpose : Understand why you need a precedent study. Are you trying to learn new techniques, understand the possible outcomes of a decision, or get inspired by past work? The answer to this question can help guide your selection process.
• Criteria : Determine the criteria that your precedent study should meet. These criteria might be related to your project’s context (e.g., geographical, cultural, social), the scale (e.g., size, complexity), the specific issue or problem you’re focusing on, or the type of solution you’re seeking.
• Search for Potential Precedents : Begin a systematic search for potential precedents. This might involve looking at academic articles, case law, architectural journals, design portfolios, historical records, or other resources depending on your field.
• Review and Select : Review the potential precedents you’ve found and assess them based on your criteria. Choose the precedent study or studies that best meet your needs.
• Justification : Be prepared to justify your choice. Whether you’re presenting your work to a supervisor, a client, or a review board, you might need to explain why you chose a particular precedent and how it’s relevant to your project.

Remember, the goal of a precedent study is to learn from the past. A good precedent is not necessarily a perfect match, but one that provides valuable lessons or insights that can inform your current project or decision-making process.

What to look for in a precedent study

Similar to the above you should aim to collect pieces of the bigger picture, which for example can include:

• Representation and presentation styles and techniques
• Architectural model styles and finishes
• Architectural diagrams
• Form and massing
• How a building interacts with light and shadow
• Window openings
• Interior finishes
• External finishes

Analyze your architectural precedents

The direction in which you analyze your precedent studies will be dependent on the nature of the precedent study itself, for example is it addressing the overall design concept, or is it a particular study into how access and circulation can be instigated and designed?

Below are a few key areas to look at:

01 Materiality – look at examples of how a building finishes work with one and another and their surrounding context, what influenced the architects decisions, how do different materials meet and interact with each other, how are junctions detailed?

02 Details – Materiality merges with and plays a large role in how a building is detailed, but aside from this you can use your precedents to influence how connections between structures and the site are made.

Look at how openings are formed, and how wall, floor and roof junctions meet each other, how a staircase connects two floors, and how it interacts with them, and how window sills are formed etc. This can be investigated on both a macro and micro level.

03 Structure – Structural strategies form the foundation (literally) of a buildings design, and so study how your precedents are supported and span over their open plan spaces, how columns and beams are sized, and is the structure exposed or hidden.

04 Scale and volume – Put simply a building must fit, and so a scale and volume precedent study would look at how buildings and sites of a similar size to your proposal interact with their surrounding environment. Are they successful, are they overbearing and if so why, and how could you avoid this? If they work well, then how do they achieve this? what can you learn?

05 Access and circulation – There are many ways to address access and so study the variations of how buildings attract their inhabitants, how do people know where the entrance is? and how do they know where to go once inside?

06 Light shadow – light and shadow play an extremely important role in how a building is experienced, and so look at how each of these are addressed; how has the architect brought light into the building? How are elements accentuated? and what does this feel like?

07 Concept development – A precedent study can often lead to and influence concept development. Study the fundamentals of how your precedents were formed and where they started, how were the volumes and spaces created, what influenced design decisions, and what was the driving force behind the project?

08 Proportions – Architecture is built upon proportion and often a buildings success is dependent on it. So study how volumes and forms interact and sit next to each other, how large and small openings sit within an elevation, how floor levels influence a buildings height and the proportions of its openings, how different materials break up massing.

09 Atmosphere – It can be particularly difficult to communicate atmosphere and emotion through a sketch or 3D model , and so using examples to demonstrate this becomes crucial.

…These are of course just a few examples of how this can be approached, and in reality each study is bespoke to a particular project and brief, and so should be tailored accordingly.

The below video further breaks down how analyze architectural precedents by examining a collection of Maggie’s centers in the UK:

Create your own precedent library

Collecting information and inspiration, has never been easier, gone are the days of scanning magazine and journal pages and collecting a vast quantities of back issues. Particularly with Pinterest , it has never been more simple to collect and build your own private libraries of resources and precedents.

In fact there is not a tool more perfect for it than the platform Pinterest provides; from multiple board and category creation, through to shared boards and group conversations, for architecture in particular Pinterest provides an extremely vast resource.

For an example of how this can be organized, visit our page here , and for guide on how to use it, click here .

That’s not to say however that this is the only method of building your own library, literature still sits firmly at the top of the list, and a private collection of books featuring your favorite architects and architecture, is an invaluable resource to have, that should be slowly built over time.

The underlying message here is to collect and keep everything, don’t throw old precedents away …add them to your library for when you next need them.

Have confidence in your design process.

Every design project begins with site analysis … start it with confidence for free!.

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A case study is a research strategy that uses "an empirical inquiry that investigates a phenomenon or setting" in its real life context. (Adapted from Groat, Architectural Research Methods , 346).

Check out these books from the library for further guidance on case studies:

• Flyvbjerg, Bent. "Five Misunderstandings About Case Study Research." Qualitative Inquiry, 12, no. 2 (April 2006): 219-245.

• Last Updated: Oct 5, 2023 8:40 AM
• URL: https://guides.lib.utexas.edu/architecture

Architect and Developer: A Case Study Handbook to Getting Started

What is the value of design.

Today, a majority of architects work solely on the design end of the development process. It follows that the cost of architectural services in a project’s total value amounts to a very small percentage –often even less than 10%– which positions architects near the bottom of the financial structure in the AEC industry.

As an architect, you are compensated for design and planning services, but it’s often the client who controls the process and determines the design brief.

In your professional life, have you experienced one of the following scenarios?

• Your client completely changed your original design brief during the project.
• Your final building is the result of many compromises and the original design intent wasn’t delivered.
• For any number of reasons, you did not earn as much as you deserve for your work on the project.

If you answered ‘Yes’, be sure to read on.

There is another way…

Architect and Developer: Build it Yourself

What if you were able to design and build your own ideas as an architect without seeking constant compromises with the client? As an “Architect and Developer” you could take over the role of the client, contractor and property manager of your projects, and reap the benefits from each of these functions.

Architects are usually in a role that implies great responsibility but disproportionally low compensation. When one considers the grievance of not having full control of a project, the value of transforming a design office into a design + development office becomes clear.

With the “Architect and Developer” model you are in complete control to design and develop your own projects. As an added bonus, being your own boss will give you greater financial satisfaction. It sounds like a great way of doing architecture – but we should also be aware of the risks it entails.

Acting as the developer also means taking on board all the risks that can arise from a project. As an “Architect and Developer” you should have a certain degree of knowledge in real estate development in order to understand the whole scope of a project – from specific market knowledge to finding and acquiring land, and how to get project funding.

But how should one start?

Learn from Those Who Have Done It Before

Successfully completing a new project typically involves facing a lot of unknowns, especially in architecture and real estate development where projects are very capital intensive. In our report we have compiled a case study series of “Architect and Developer” practitioners who all developed their own projects.

These architects all share one common trait which differentiates them from traditional developers: they all used their architectural skillset, meaning their deep understanding of cities, space, light and texture to develop beautiful, well-planned and creative buildings which add imaginative, innovative and creative value to the urban environment.

By eliminating the clients and contractors from the design and building process, these architects became the owners and directors of their projects. And, by learning and applying the skillset and tools of developers, they took initiative and created their projects exactly how they want them.

In our report you can read 10 interviews of practicing Architect and Developers who share their stories and how they got started with the first projects. Learn from their first-hand experiences and be inspired to start with your own project.

Report Topics

Featured architect and developer case studies.

Learn from these practicing “Architect and Developer” and how their started to get their first projects of the ground.

Get the Architect and Developer Report now

• DIGITAL REPORT (PDF) – Instant download of the digital only report as a pdf file.
• BUSINESS INSIGHTS – and learnings from “Architect and Developer” practitioners.
• CASE STUDIES – 11 In-depth interview case studies from around the globe.
• and much more…

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CASE STUDY AS A TOOL FOR ARCHITECTURAL RESEARCH

Research has been part of human activity as man remains an inquisitive animal. So many methods are employed in the field of research which case study is one of them. Case studies are widely used in most professions, including medicine, law, engineering, business, planning and architecture. The use of case study as a method of inquiry is becoming increasingly common in the study and practice of architecture. The primary body of knowledge in architecture is built up through written and visual documentation of projects. It is imperative for architects to think about case study research within a performance-based framework that links design decision to measurable outcome. Therefore, this paper shall reveal information on how to conduct a facility-based case study that will yield useful information for architectural study and practice. The objective of this paper is to argue for a standardized approach for case studies, present a framework and methodology providing guidance on how to conduct case studies. A desired end goal of case study research is to develop a framework of facility database that could be used to inform the development of design guidelines and provide necessary information for study and best practice.

Related Papers

In Flux: Design education in a changing world (Proceedings of the 5th International DEFSA Conference, 3-5 October 2007, Cape Town, South Africa, ISBN 978-0-620-39561-8), cd-rom.

Mike Christenson

This paper describes the results of an academic assignment given to a group of undergraduate architectural design students, in which each student was required to conduct research and compose case-study reports on selected works of architecture to support individual identification of each of these works as “good”, “bad”, or “ugly”. Each student was free to select whichever works of architecture they wished as subjects for their research, and to illustrate these works by whatever means they found appropriate. Each student selected several buildings as examples, and each student composed a multi-page illustrated and written report summarizing their research and concluding with specific attributions for each selected work.

Bob Giddings

This Research Roadmap aims to establish the principal issues in Architectural Design and Management. It is an advance for architectural research to be organised in this way; and addresses six themes: Conceptual Framework State of the Art Future Scenario Development Strategy Research Contribution Research Agenda It sets out the scope for research and innovation, and suggests how this may receive more prominence on the international stage.

Mirjana Devetakovic

Abstract In this paper the authors discuss challenging interrelations between the contemporary architectural practice and the expanding facility management (FM) sector. After defining FM and determining the part of it that is directly dependent on an architectural expertise, the authors identify possible interests in combining knowledge between the two fields, both dealing with the built environment. The empirical part of the research is a study of the current development of FM concepts and strategies in Serbia, and examination of the position and a possible impact of the local architectural practice. A systematization of local real-estate from the point of FM includes three different groups of objects: the ones with integrated FM strategy in the early design stage; the ones with imported FM strategy from international firms; and the last incomparably largest group of objects that esperately need an appropriate FM concept. The methodology of tracking the FM related knowledge has been applied with the aim to recognize key actors in the FM knowledge exchange on the national level, as well as to understand current position and propose possible activities for the local architectural community. Keywords: Facility management, architectural practice, Serbia Citation: Devetakovic, Mirjana, and Radojevic, Milan. "Facility Management: A Paradigm for Expanding the Scope of Architectural Practice," in ArchNet-IJAR: International Journal of Architectural Research, vol. 1, issue 3 (2007).

European Journal of Engineering and Formal Sciences

Leyda Sarmiento

Renewable Energy

Dean Hawkes

e-Design in …

Danniel Roumian

Peter Andreas Sattrup

As Architectural Research is in the process of re-establishing itself as a research discipline according to university standards, it may appear as if the pool of knowledge generated by more than three millennia of experimental research and its internal systems of evaluation are being grossly devalued and colonized by attitudes to research that are imported or even imposed from the outside. Does architectural research have to rely on imported theory from philosophy, the social or the natural sciences in order to meet societal acceptance of its relevance? What constitutes architectural research as a particular research discipline, what are its main characteristics and how can its paradigms, methodologies, strategies and tactics be described? What should be essential aspects of doctoral curriculae in architecture? Discussing Groat and Wang’s Architectural Research Methods in the light of Reflected Practice, and Organizational Knowledge Creation, a framework is presented that includes e...

Rapit Suvanajata

ARbD (book of Abstracts)

João D E V E R N A Bilstein

Research by design is a broader concept that includes “practice-based research” and “practice-led research” which means that we are talking about two kinds of methodologies of research: one involves research through practice and the other involves research about practice. The difference is methodological, because one is research where the inquiry is leading to new understandings about and within the processes of design conception while the other is research about something that does not yet exist and which uses architectural practice as the research method. In terms of the general concept of architectural research, this conference adopts the definition given in the EAAE Research Charter (2012), which we helped to develop: “Architectural research is original investigation undertaken in order to generate knowledge, insights and understanding based on competences, methods and tools proper to the discipline of architecture. It has its own particular knowledge base, mode, scope, tactics and strategies.” And in turn, research by design is defined as “any kind of inquiry in which (…) the architectural design process forms the pathway through which new insights, knowledge, practices or products come into being. It generates critical inquiry through design work.”

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Three arches for a roof – case study of a multi-disciplinary design process

• Case Studies
• Published: 17 March 2022
• Volume 2 , pages 83–109, ( 2022 )

Cite this article

• Tilke Devriese   ORCID: orcid.org/0000-0002-8259-8477 1 ,
• Maarten Van Den Driessche   ORCID: orcid.org/0000-0001-7074-5049 1 &
• Jan Belis   ORCID: orcid.org/0000-0001-9248-2171 1  

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In this article, the design process for the remarkable curved roof for a sports hall in Genk (BE) is traced. The project was granted to the partnership of young architects and a renowned office for structural engineering. The new building is roofed with three oversized arches, proposed as a shell structure in concrete in the competition, but executed as a steel truss system. The research is based on files from the archives of both the architect and the structural engineer. Close observations are made on six key moments in this design process. For these pivotal points sketches, documents and communication, are discussed in detail. The goal of this article is to make observations specifically on the collaborative design process between the architect and the engineer, in the specific context of a design competition. The research exposes the messy reality of a design process. It is observed how the final structure got its form, how design decisions were made and how the collaboration defined the project. It is illustrated how relative positions of team members evolve throughout the process and how progressive insight, conflict and mutual understanding are key during the design.

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The design was never executed, but has only been discarded in 2012, two years after this competition. [ 12 ]

The notes in Fig.  7 (Right) state ‘concrete + isolation’ and ‘25% of glass bricks’, which seems to denote the emphasized valley in the sketch.

The part on acoustics states: ‘To achieve good room acoustics, we first look at the geometry of the hall. The volume does not have a standard beam shape, but is conceived as a curved shell structure. This limits the number of flat, even walls and thus the risk of bothersome echoes.’

This statement is made in the competition proposal without further explanation. The topic is addressed again further in the process, and shortly elaborated upon in footnote 9 of this article. It is shown throughout this text how several options to address this problem are scrutinized (equilibrate through thickness of the shells, add outer flanges, tension elements etcetera). In the end it can be seen however that this topic is not of primary importance for the structure, since the arches are executed with a completely different structural system.

One question during the jury is on the structural aspects, which seems to indicate that the coloured scheme (Fig.  12 ) was indeed misunderstood: ‘The diagram showing the arch action in the "side planes" of the arches shows that the forces transmitted are minimal in the centre of these "side planes". Does this allow to save material here, so that the arch transfers its forces at four points?’.

The written answer in the jury report [ 20 ] is vague: ‘You will always need the tension element between the arches. In other words: the beam will always be there. The hollow beam in which the partition wall hangs actually acts as a tension element. This construction works in the three directions. (note: in the competition design partition walls to subdivide the sports halls were proposed. The rails were integrated in the longitudinal beams in between the arches).

Another example of this tactical approach is in the use of references: The competition proposal shows one reference: the Fronton Recoletos in Madrid by Zuazo Egaldo and Eduardo Torroja. [ 18 ] This is remarkable, since they were well aware of the design of Christian Kerez shown in Fig.  7 .

In the beforementioned interview with Bel Architects [ 4 ], the architects are complimented with the fact that they share their sources of inspiration, specifically referring to the Fronton Recoletos in this competition proposal. The architects answer that they never show all their references, because it would be contra-productive to put all your cards on the table. They add that this reference was chosen to show that in ‘those years’ not only beautiful shells were made, but as well that it is possible to get beautiful natural light inside with them, which is very convincing. This at least illustrates the architects to be well aware of what to say, and what not to say during the competition phase.

The engineers will publish 6 ‘Study Reports’ throughout the course of the design process. These are often related to intermediary deadlines in the process and summarize the (current state of the) study of the engineers.

From left to right and from top to bottom, results are shown for: normal forces in the direction of the curvature and in longitudinal direction, moments in longitudinal direction, moments in the direction of the curvature, torsional moments and deformations in vertical direction. In none of these diagrams the boundary conditions are identifiable, nor is it clear what loads are used.

‘The concatenation of different bows, with similar spans and supports on different heights, results in variable thrusts. This imbalance will have to be compensated in the intermediate supports, or transferred by the outer shells to the outer supports. Another idea is to increase the load on the outer bows. Because of this, their thrust increases, until they compensate the intermediate thrust .’ [ 26 ] The thickness of 32 cm for the outer arches linearly follows from the ratio of thrusts of the different arches and the proposed thickness of 25 cm to meet the equilibrium shape for all load combinations in the inner arch.

When the equilibrium shape is not met, bending moments will occur in addition to compression forces.

Only in the case of smaller prefabricated elements, in which several connections have to be made, it is advantageous to reduce bending moments as much as possible. It can as well be noted that a section that has to cope with bending benefits from larger lever arms. Bending moments thus might as well become decisive for the thickness as well at a certain point.

The table was added in the second (and final) version of Study Report 1.

Laurent Ney.

See black dots on Fig.  22

See also no.11 in Fig.  2 of [ 7 ]

In the same way, the roof is only a part of the design story for the whole building.

This is an alternative to the idea to equilibrate with variable thicknesses, as was proposed in the first study report. See footnote 9.

Hangars in Antwerp by André Paduart, for which especially a reusable formwork system would have been developed. A hall in the city of Mons (BE), by René Greisch. And the Nekkerhall in Mechelen (BE). The las two are fully prefabricated, and roof the hall with one arch, not a concatenation of arches.

A sports hall is not a club in the midst of a living area, the mass of the concrete facilitates noise not to be transferred to the outside, but has few advantage for the internal acoustic quality. Fire protection of steel is more labour-intensive than for concrete, but is standard practice.

In the previous paper on this case-study was indicated that the purpose of these ribs was unclear. Further research however brought clarification.

See footnote 3.

The staunch attitude of the engineers might as well be informed by the price estimation they received from a contractor specialized in prefabricated concrete. Of several options, only the most basic one would be feasible within the current budget. This answer arrived in the architects mailbox between Laurent Ney’s phone call and the architects list of questions. They however forward it to the engineers, just asking them to check how the estimation relates to the budget for the roof structure. [ 41 ]

For the large spans the height over span ratio is 1/8,125 (4 m over 32,5 m). In rules of thumb for steel trusses for roofs a ratio of 1/10–15 is used. [ 46 ]

‘The architectural quality of your design is in the SPACE. I think it is a pity to endanger the design with such an inefficient choice of material.’ [ 44 ]

In the beforementioned text on Ney & Partners:[ 3 ] (…) all the firm’s projects bear his own personal signature. Laurent Ney is an author in the original sense of the word. In another article [ 48 ] it is explained that this is especially true for bridges. Their work is often less visible when they collaborate with architects on building projects. ‘‘This is our role’, Ney says. ‘We are specialists in structure’. Although their hand is clearly visible in the final project, it can be seen in how design proposals are formulated, that their supportive position is maintained.

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Team Vlaams Bouwmeester (2010) Selectiebeslissing bij de Open Oproep tot kandidatuurstelling 18 | 2009, de projectgebonden selectie m.b.t. het project 13:Volledige studieopdracht voor de renovatie en uitbreiding van het Stedelijk Sportcentrum te Genk, Team Vlaams Bouwmeester - Vlaamse Overheid

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Acknowledgements

The authors wish to express gratitude to Bel Architects and Ney & Partners to grant full access to their archives of the project, to make this case-study possible.

Both as well approved the manuscript of this article for publication.

The authors have no relevant financial or non-financial interests to disclose.

The authors have no competing interests to declare that are relevant to the content of this article.

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Devriese, T., Van Den Driessche, M. & Belis, J. Three arches for a roof – case study of a multi-disciplinary design process. Archit. Struct. Constr. 2 , 83–109 (2022). https://doi.org/10.1007/s44150-022-00024-1

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The promise and the reality of gen AI agents in the enterprise

The evolution of generative AI (gen AI) has opened the door to great opportunities across organizations, particularly regarding gen AI agents—AI-powered software entities that plan and perform tasks or aid humans by delivering specific services on their behalf. So far, adoption at scale across businesses has faced difficulties because of data quality, employee distrust, and cost of implementation. In addition, capabilities have raced ahead of leaders’ capacity to imagine how these agents could be used to transform work.

However, as gen AI technologies progress and the next-generation agents emerge, we expect more use cases to be unlocked, deployment costs to decrease, long-tail use cases to become economically viable, and more at-scale automation to take place across a wider range of enterprise processes, employee experiences, and customer interfaces. This evolution will demand investing in strong AI trust and risk management practices and policies as well as platforms for managing and monitoring agent-based systems.

In this interview, McKinsey Digital’s Barr Seitz speaks with senior partners Jorge Amar and Lari Hämäläinen and partner Nicolai von Bismarck to explore the evolution of gen AI agents and how companies can and should implement the technology, where the pools of value lie for the enterprise as a whole. They particularly explore what these developments mean for customer service. An edited transcript of the conversation follows.

Barr Seitz: What exactly is a gen AI agent?

Lari Hämäläinen: When we talk about gen AI agents, we mean software entities that can orchestrate complex workflows, coordinate activities among multiple agents, apply logic, and evaluate answers. These agents can help automate processes in organizations or augment workers and customers as they perform processes. This is valuable because it will not only help humans do their jobs better but also fully digitalize underlying processes and services.

For example, in customer services, recent developments in short- and long-term memory structures enable these agents to personalize interactions with external customers and internal users, and help human agents learn. All of this means that gen AI agents are getting much closer to becoming true virtual workers that can both augment and automate enterprise services in all areas of the business, from HR to finance to customer service. That means we’re well on our way to automating a wide range of tasks in many service functions while also improving service quality.

Barr Seitz: Where do you see the greatest value from gen AI agents?

Jorge Amar: We have estimated that gen AI enterprise use cases  could yield $2.6 trillion to $4.4 trillion annually in value across more than 60 use cases. 1 “ The economic potential of generative AI: The next productivity frontier ,” McKinsey, June 14, 2023. But how much of this value is realized as business growth and productivity will depend on how quickly enterprises can reimagine and truly transform work in priority domains—that is, user journeys, processes across an entire chain of activities, or a function.

Gen-AI-enabled agents hold the promise of accelerating the automation of a very long tail of workflows that would otherwise require inordinate amounts of resources to implement. And the potential extends even beyond these use cases: 60 to 70 percent of the work hours in today’s global economy could theoretically be automated by applying a wide variety of existing technology capabilities, including generative AI, but doing so will require a lot in terms of solutions development and enterprise adoption.

Consider customer service. Currently, the value of gen AI agents in the customer service environment is going to come either from a volume reduction or a reduction in average handling times. For example, in work we published earlier this year, we looked at 5,000 customer service agents using gen AI and found that issue resolution increased by 14 percent an hour, while time spent handling issues went down 9 percent. 2 “ The economic potential of generative AI: The next productivity frontier ,” McKinsey, June 14, 2023.

About QuantumBlack, AI by McKinsey

QuantumBlack, McKinsey’s AI arm, helps companies transform using the power of technology, technical expertise, and industry experts. With thousands of practitioners at QuantumBlack (data engineers, data scientists, product managers, designers, and software engineers) and McKinsey (industry and domain experts), we are working to solve the world’s most important AI challenges. QuantumBlack Labs is our center of technology development and client innovation, which has been driving cutting-edge advancements and developments in AI through locations across the globe.

The other area for value is agent training. Typically, we see that it takes somewhere between six to nine months for a new agent to perform at par with the level of more tenured peers. With this technology, we see that time come down to three months, in some cases, because new agents have at their disposal a vast library of interventions and scripts that have worked in other situations.

Over time, as gen AI agents become more proficient, I expect to see them improve customer satisfaction and generate revenue. By supporting human agents and working autonomously, for example, gen AI agents will be critical not just in helping customers with their immediate questions but also beyond, be that selling new services or addressing broader needs. As companies add more gen AI agents, costs are likely to come down, and this will open up a wider array of customer experience options for companies, such as offering more high-touch interactions with human agents as a premium service.

Barr Seitz: What are the opportunities you are already seeing with gen AI agents?

Jorge Amar: Customer care will be one of the first but definitely not the only function with at-scale AI agents. Over the past year, we have seen a lot of successful pilots with gen AI agents helping to improve customer service functions. For example, you could have a customer service agent who is on the phone with a customer and receives help in real time from a dedicated gen AI agent that is, for instance, recommending the best knowledge article to refer to or what the best next steps are for the conversation. The gen AI agent can also give coaching on behavioral elements, such as tone, empathy, and courtesy.

It used to be the case that dedicating an agent to an individual customer at each point of their sales journey was cost-prohibitive. But, as Lari noted, with the latest developments in gen AI agents, now you can do it.

Nicolai von Bismarck: It’s worth emphasizing that gen AI agents not only automate processes but also support human agents. One thing that gen AI agents are so good at, for example, is in helping customer service representatives get personalized coaching not only from a hard-skill perspective but also in soft skills like understanding the context of what is being said. We estimate that applying generative AI to customer care functions could increase productivity by between 30 to 45 percent. 3 “ The economic potential of generative AI: The next productivity frontier ,” McKinsey, June 14, 2023.

Jorge Amar: Yes, and in other cases, gen AI agents assist the customer directly. A digital sales assistant can assist the customer at every point in their decision journey by, for example, retrieving information or providing product specs or cost comparisons—and then remembering the context if the customer visits, leaves, and returns. As those capabilities grow, we can expect these gen AI agents to generate revenue through upselling.

[For more on how companies are using gen AI agents, see the sidebar, “A closer look at gen AI agents: The Lenovo experience.”]

Barr Seitz: Can you clarify why people should believe that gen AI agents are a real opportunity and not just another false technology promise?

A closer look at gen AI agents: The Lenovo experience

Three leaders at Lenovo —Solutions and Services Group chief technology officer Arthur Hu, COO and head of strategy Linda Yao, and Digital Workplace Solutions general manager Raghav Raghunathan—discuss with McKinsey senior partner Lari Hämäläinen and McKinsey Digital’s Barr Seitz how the company uses generative AI (gen AI) agents.

Barr Seitz: What existing gen AI agent applications has Lenovo been running and what sort of impact have you seen from them?

Arthur Hu: We’ve focused on two main areas. One is software engineering. It’s the low-hanging fruit to help our people enhance speed and quality of code production. Our people are already getting 10 percent improvements, and we’re seeing that increase to 15 percent as teams get better at using gen AI agents.

The second one is about support. We have hundreds of millions of interactions with our customers across online, chat, voice, and email. We’re applying LLM [large language model]-enhanced bots to address customer issues across the entire customer journey and are seeing some great improvements already. We believe it’s possible to address as much as 70 to 80 percent of all customer interactions without needing to pull in a human.

Linda Yao: With our gen AI agents helping support customer service, we’re seeing double-digit productivity gains on call handling time. And we’re seeing incredible gains in other places too. We’re finding that marketing teams, for example, are cutting the time it takes to create a great pitch book by 90 percent and also saving on agency fees.

Barr Seitz: How are you getting ready for a world of gen AI agents?

Linda Yao: I was working with our marketing and sales training teams just this morning as part of a program to develop a learning curriculum for our organization, our partners, and our key customers. We’re figuring out what learning should be at all levels of the business and for different roles.

Arthur Hu: On the tech side, employees need to understand what gen AI agents are and how they can help. It’s critical to be able to build trust or they’ll resist adopting it. In many ways, this is a demystification exercise.

Raghav Raghunathan: We see gen AI as a way to level the playing field in new areas. You don’t need a huge talent base now to compete. We’re investing in tools and workflows to allow us to deliver services with much lower labor intensity and better outcomes.

Barr Seitz: What sort of learning programs are you developing to upskill your people?

Linda Yao: The learning paths for managers, for example, focus on building up their technical acumen, understanding how to change their KPIs because team outputs are changing quickly. At the executive level, it’s about helping leaders develop a strong understanding of the tech so they can determine what’s a good use case to invest in, and which one isn’t.

Arthur Hu: We’ve found that as our software engineers learn how to work with gen AI agents, they go from basically just chatting with them for code snippets to developing much broader thinking and focus. They start to think about changing the software workflow, such as working with gen AI agents on ideation and other parts of the value chain.

Raghav Raghunathan: Gen AI provides an experiential learning capability that’s much more effective. They can prepare sales people for customer interactions or guide them during sales calls. This approach is having a much greater impact than previous learning approaches. It gives them a safe space to learn. They can practice their pitches ahead of time and learn through feedback in live situations.

Barr Seitz: How do you see the future of gen AI agents evolving?

Linda Yao: In our use cases to date, we’ve refined gen AI agents so they act as a good assistant. As we start improving the technology, gen AI agents will become more like deputies that human agents can deploy to do tasks. We’re hoping to see productivity improvements, but we expect this to be a big improvement for the employee experience. These are tasks people don’t want to do.

Arthur Hu: There are lots of opportunities, but one area we’re exploring is how to use gen AI to capture discussions and interactions, and feed the insights and outputs into our development pipeline. There are dozens of points in the customer interaction journey, which means we have tons of data to mine to understand complex intent and even autogenerate new knowledge to address issues.

Jorge Amar: These are still early days, of course, but the kinds of capabilities we’re seeing from gen AI agents are simply unprecedented. Unlike past technologies, for example, gen AI not only can theoretically handle the hundreds of millions of interactions between employees and customers across various channels but also can generate much higher-quality interactions, such as delivering personalized content. And we know that personalized service is a key driver of better customer service. There is a big opportunity here because we found in a survey of customer care executives we ran that less than 10 percent of respondents  in North America reported greater-than-expected satisfaction with their customer service performance. 4 “ Where is customer care in 2024? ,” McKinsey, March 12, 2024.

Lari Hämäläinen: Let me take the technology view. This is the first time where we have a technology that is fitted to the way humans interact and can be deployed at enterprise scale. Take, for example, the IVR [interactive voice response] experiences we’ve all suffered through on calls. That’s not how humans interact. Humans interact in an unstructured way, often with unspoken intent. And if you think about LLMs [large language models], they were basically created from their inception to handle unstructured data and interactions. In a sense, all the technologies we applied so far to places like customer service worked on the premise that the customer is calling with a very structured set of thoughts that fit predefined conceptions.

Barr Seitz: How has the gen AI agent landscape changed in the past 12 months?

Lari Hämäläinen: The development of gen AI has been extremely fast. In the early days of LLMs, some of their shortcomings, like hallucinations and relatively high processing costs, meant that models were used to generate pretty basic outputs, like providing expertise to humans or generating images. More complex options weren’t viable. For example, consider that in the case of an LLM with just 80 percent accuracy applied to a task with ten related steps, the cumulative accuracy rate would be just 11 percent.

Today, LLMs can be applied to a wider variety of use cases and more complex workflows because of multiple recent innovations. These include advances in the LLMs themselves in terms of their accuracy and capabilities, innovations in short- and long-term memory structures, developments in logic structures and answer evaluation, and frameworks to apply agents and models to complex workflows. LLMs can evaluate and correct “wrong” answers so that you can have much higher accuracy. With an experienced human in the loop to handle cases that are identified as tricky, then the joint human-plus-machine outcome can generate great quality and great productivity.

Finally, it’s worth mentioning that a lot of gen AI applications beyond chat have been custom-built in the past year by bringing different components together. What we are now seeing is the standardization and industrialization of frameworks to become closer to “packaged software.” This will speed up implementation and improve cost efficiency, making real-world applications even more viable, including addressing the long-tail use cases in enterprises.

Barr Seitz: What sorts of hurdles are you seeing in adopting the gen AI agent technology for customer service?

Nicolai von Bismarck: One big hurdle we’re seeing is building trust across the organization in gen AI agents. At one bank, for example, they knew they needed to cut down on wrong answers to build trust. So they created an architecture that checks for hallucinations. Only when the check confirms that the answer is correct is it released. And if the answer isn’t right, the chatbot would say that it cannot answer this question and try to rephrase it. The customer is then able to either get an answer to their question quickly or decide that they want to talk to a live agent. That’s really valuable, as we find that customers across all age groups — even Gen Z — still prefer live phone conversations for customer help and support. .

Jorge Amar: We are seeing very promising results, but these are in controlled environments with a small group of customers or agents. To scale these results, change management will be critical. That’s a big hurdle for organizations. It’s much broader than simply rolling out a new set of tools. Companies are going to need to rewire how functions work so they can get the full value from gen AI agents.

Take data, which needs to be in the right format and place for gen AI technologies to use them effectively. Almost 20 percent of most organizations, in fact, see data as the biggest challenge to capturing value with gen AI. 5 “ The state of AI in 2023: Generative AI’s breakout year ,” McKinsey, August 1, 2023. One example of this kind of issue could be a chatbot sourcing outdated information, like a policy that was used during COVID-19, in delivering an answer. The content might be right, but it’s hopelessly out of date. Companies are going to need to invest in cleaning and organizing their data.

In addition, companies need a real commitment to building AI trust and governance capabilities. These are the principles, policies, processes, and platforms that assure companies are not just compliant with fast-evolving regulations—as seen in the recent EU AI law and similar actions in many countries—but also able to keep the kinds of commitments that they make to customers and employees in terms of fairness and lack of bias. This will also require new learning, new levels of collaboration with legal and risk teams, and new technology to manage and monitor systems at scale.

Change needs to happen in other areas as well. Businesses will need to build extensive and tailored learning curricula for all levels of the customer service function—from managers who will need to create new KPIs and performance management protocols to frontline agents who will need to understand different ways to engage with both customers and gen AI agents.

The technology will need to evolve to be more flexible and develop a stronger life cycle capability to support gen AI tools, what we’d call MLOps [machine learning operations] or, increasingly, gen AI Ops [gen AI operations]. The operating model will need to support small teams working iteratively on new service capabilities. And adoption will require sustained effort and new incentives so that people learn to trust the tools and realize the benefits. This is particularly true with more tenured agents, who believe their own skills cannot be augmented or improved on with gen AI agents. For customer operations alone, we’re talking about a broad effort here, but with more than $400 billion of potential value from gen AI at stake, it’s worth it. 6 “ The economic potential of generative AI: The next productivity frontier ,” McKinsey, June 14, 2023.

Barr Seitz: Staying with customer service, how will gen AI agents help enterprises?

Jorge Amar: This is a great question, because we believe the immediate impact comes from augmenting the work that humans do even as broader automation happens. My belief is that gen AI agents can and will transform various corporate services and workflows. It will help us automate a lot of tasks that were not adding value while creating a better experience for both employees and customers. For example, corporate service centers will become more productive and have better outcomes and deliver better experiences.

In fact, we’re seeing this new technology help reduce employee attrition. As gen AI becomes more pervasive, we may see an emergence of more specialization in service work. Some companies and functions will lead adoption and become fully automated, and some may differentiate by building more high-touch interactions.

Nicolai von Bismarck: As an example, we’re seeing this idea in practice at one German company, which is implementing an AI-based learning and coaching engine. And it’s already seeing a significant improvement in the employee experience as measured while it’s rolling this out, both from a supervisor and employee perspective, because the employees feel that they’re finally getting feedback that is relevant to them. They’re feeling valued, they’re progressing in their careers, and they’re also learning new skills. For instance, instead of taking just retention calls, they can now take sales calls. This experience is providing more variety in the work that people do and less dull repetition.

Lari Hämäläinen: Let me take a broader view. We had earlier modeled a midpoint scenario when 50 percent of today’s work activities could be automated to occur around 2055. But the technology is evolving so much more quickly than anyone had expected—just look at the capabilities of some LLMs that are approaching, and even surpassing, in certain cases, average human levels of proficiency. The innovations in gen AI have helped accelerate that midpoint scenario by about a decade. And it’s going to keep getting faster, so we can expect the adoption timeline to shrink even further. That’s a crucial development that every executive needs to understand.

Jorge Amar is a senior partner in McKinsey’s Miami office, Lari Hämäläinen is a senior partner in the Seattle office, and Nicolai von Bismarck is a partner in the Boston office. Barr Seitz is director of global publishing for McKinsey Digital and is based in the New York office.

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• Published: 21 May 2024

A spatial architecture-embedding HLA signature to predict clinical response to immunotherapy in renal cell carcinoma

• Lisa Kinget   ORCID: orcid.org/0000-0002-7479-4793 1 , 2   na1 ,
• Stefan Naulaerts 3   na1 ,
• Jannes Govaerts 3 ,
• Isaure Vanmeerbeek 3 ,
• Jenny Sprooten 3 ,
• Raquel S. Laureano 3 ,
• Nikolina Dubroja 4 ,
• Gautam Shankar 4 ,
• Francesca M. Bosisio   ORCID: orcid.org/0000-0002-8874-2003 4 ,
• Eduard Roussel 5 ,
• Annelies Verbiest 1 ,
• Francesca Finotello   ORCID: orcid.org/0000-0003-0712-4658 6 ,
• Markus Ausserhofer 6 ,
• Diether Lambrechts   ORCID: orcid.org/0000-0002-3429-302X 7 , 8 ,
• Bram Boeckx 7 , 8 ,
• Agnieszka Wozniak 1 ,
• Louis Boon 9 ,
• Johan Kerkhofs 10 ,
• Jessica Zucman-Rossi   ORCID: orcid.org/0000-0002-5687-0334 11 ,
• Maarten Albersen 5 ,
• Marcella Baldewijns 12 ,
• Benoit Beuselinck   ORCID: orcid.org/0000-0001-7427-9102 1 , 2 &
• Abhishek D. Garg   ORCID: orcid.org/0000-0002-9976-9922 3  

Nature Medicine ( 2024 ) Cite this article

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• Cancer immunotherapy
• Renal cell carcinoma
• Tumour biomarkers
• Tumour immunology

An important challenge in the real-world management of patients with advanced clear-cell renal cell carcinoma (aRCC) is determining who might benefit from immune checkpoint blockade (ICB). Here we performed a comprehensive multiomics mapping of aRCC in the context of ICB treatment, involving discovery analyses in a real-world data cohort followed by validation in independent cohorts. We cross-connected bulk-tumor transcriptomes across >1,000 patients with validations at single-cell and spatial resolutions, revealing a patient-specific crosstalk between proinflammatory tumor-associated macrophages and (pre-)exhausted CD8 + T cells that was distinguished by a human leukocyte antigen repertoire with higher preference for tumoral neoantigens. A cross-omics machine learning pipeline helped derive a new tumor transcriptomic footprint of neoantigen-favoring human leukocyte antigen alleles. This machine learning signature correlated with positive outcome following ICB treatment in both real-world data and independent clinical cohorts. In experiments using the RENCA-tumor mouse model, CD40 agonism combined with PD1 blockade potentiated both proinflammatory tumor-associated macrophages and CD8 + T cells, thereby achieving maximal antitumor efficacy relative to other tested regimens. Thus, we present a new multiomics and spatial map of the immune-community architecture that drives ICB response in patients with aRCC.

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Tumor microenvironment heterogeneity in bladder cancer identifies biologically distinct subtypes predicting prognosis and anti-PD-L1 responses

Identification of an immunogenic cell death-related gene signature predicts survival and sensitivity to immunotherapy in clear cell renal carcinoma

Mapping the immune environment in clear cell renal carcinoma by single-cell genomics

Data availability.

All relevant newly created data for this study (that is, bulk RNA-seq of inhouse immunotherapy-treated RCC patients) are available on Synapse ( syn53162048 ). Due to GDPR sensitivities, the HLA haplotyping data and raw RNA-seq data are not publicly available but can be provided for research purposes upon reasonable request. Other publicly available datasets used are available elsewhere: (1) clinical and transcriptomics data of the JAVELIN 101 cohort as reported in Supplementary Data by Motzer et al. 20 ( https://doi.org/10.1038/s41591-020-1044-8 ); (2) survival and transcriptomics data from cohorts included in the TCGA PanCancerAtlas Immune Response Working Group’s Cancer Research Institute (CRI) iAtlas Explorer 67 ; (3) TCGA KIRC data, publicly available from Xena ( https://xenabrowser.net/datapages/?cohort=TCGA%20TARGET%20GTEx&removeHub=https%3A%2F%2Fxena.treehouse.gi.ucsc.edu%3A443 ), FireBrowse portal (a Broad Institute GDAC Firehose analyses pipeline: http://firebrowse.org/?cohort=KIRC ); (4) single-cell cohort of Bi et al. 15 ; (5) public spatial transcriptomics data from clear-cell renal cell carcinoma samples through GEO ( GSE175540 ); (6) public transcriptomics data from various murine preclinical tumor models obtained through GEO ( GSE85509 ); (7) single-cell transcriptomics and metadata of public datasets of Krishna et al. 42 and Braun et al. 14 retrieved from BioTuring database (Talk2Data v. 4, accessed on 17 November 2023); (8) transcriptomics and clinical data from the SuMR trial and SCOTRRCC study 39 retrieved from GEO ( GSE67818 ). Source data are provided with this paper.

Code availability

All relevant code for this study is available on Synapse ( syn53162048 ).

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Acknowledgements

We thank Y. Vano (Hôpital Européen Georges Pompidou, Université de Paris Cité, France) and M. Meylan (Centre de Recherche des Cordeliers, INSERM, Université de Paris Cité, Sorbonne Université, Paris, France) for providing outcome data associated with the Visium spatial transcriptomics samples from BIONIKK. This study is supported by Kom op tegen Kanker (Stand up to Cancer), the Flemish cancer society via Emmanuel van der Schueren (EvDS) PhD fellowship (projectID: 3328; to L.K.), Research Foundation Flanders (FWO) (Fundamental Research Grant, G0B4620N to A.D.G.; Excellence of Science/EOS grant, 30837538, for ‘DECODE’ consortium, to A.D.G.), KU Leuven (C1 grant, C14/19/098 to A.D.G.; C3 grant, C3/21/037 or C3/23/067 to A.D.G.), and VLIR-UOS (iBOF grant, iBOF/21/048, for ‘MIMICRY’ consortium to A.D.G.). I.V. and R.S.L. are supported by FWO-SB PhD Fellowship (1S06821N to I.V. and 1S44123N to R.S.L.). J.S. is funded by KU Leuven’s Postdoctoral Mandate (PDM) fellowship (PDMT2/23/071). S.N. is funded by Stichting tegen Kanker Postdoctoral fellowship (2023-046). B. Beuselinck is supported by FWO Senior Clinical Investigator Fellowship (1801520N). F.F. was supported by the Austrian Science Fund (FWF) (no. T 974-B30 and FG 2500-B) and by the Oesterreichische Nationalbank (OeNB) (no. 18496). The computational results presented here have been achieved in part using the LEO HPC infrastructure of the University of Innsbruck. The results shown here are in part based upon data generated by TCGA Research Network ( https://cancergenome.nih.gov ).

Author information

These authors contributed equally: Lisa Kinget, Stefan Naulaerts.

Authors and Affiliations

Laboratory of Experimental Oncology, KU Leuven, Leuven, Belgium

Lisa Kinget, Annelies Verbiest, Agnieszka Wozniak & Benoit Beuselinck

Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium

Lisa Kinget & Benoit Beuselinck

Laboratory of Cell Stress and Immunity (CSI), Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium

Stefan Naulaerts, Jannes Govaerts, Isaure Vanmeerbeek, Jenny Sprooten, Raquel S. Laureano & Abhishek D. Garg

Translational Cell and Tissue Research, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium

Nikolina Dubroja, Gautam Shankar & Francesca M. Bosisio

Department of Urology, University Hospitals Leuven, Leuven, Belgium

Eduard Roussel & Maarten Albersen

Department of Molecular Biology, Digital Science Center (DiSC), University of Innsbruck, Innsbruck, Austria

Francesca Finotello & Markus Ausserhofer

Laboratory of Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium

Diether Lambrechts & Bram Boeckx

VIB Center for Cancer Biology, VIB, Leuven, Belgium

JJP Biologics, Warsaw, Poland

Histocompatibility and Immunogenetics Laboratory, Belgian Red Cross-Flanders, Mechelen, Belgium

Johan Kerkhofs

Inserm, UMRS-1138, Génomique fonctionnelle des tumeurs solides, Centre de recherche des Cordeliers, Paris, France

Jessica Zucman-Rossi

Department of Pathology, University Hospitals Leuven, Leuven, Belgium

Marcella Baldewijns

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Contributions

L.K. was involved in sample collection and RNA extraction, performed the bulk- and scRNA-seq bioinformatics analyses, coordinated and managed the research efforts, created the figures and cowrote the paper. S.N. designed the ML model and MILAN interaction analysis workflow, performed the VISIUM analyses and provided bioinformatical guidance and critical data interpretation and statistics discussion. J.G., I.V., J.S., R.S.L. performed the cell culture, in vivo experiments, and flow cytometry analysis, and helped with paper revision and figure preparation. N.D. performed the MILAN staining and image acquisition. G.S. performed the MILAN image analysis. F.M.B. coordinated the MILAN pipeline. E.R., A.V., B. Beuselinck, L.K., M.B., M. Albersen and A.W. helped with sample collection of the Leuven cohort. E.R., A.V. and L.K. performed bulk RNA extraction. M.B. performed pathological review of samples. D.L. and B. Boeckx helped with bulk RNA sequencing and DNA extraction of the Leuven cohort. L.B. helped with antibody analyses. M. Ausserhofer and F.F. performed the genomic analysis on the TCGA KIRC dataset. J.K. helped with HLA analyses. J.Z.-R. helped with bulk RNA sequencing of the Leuven cohort. M. Albersen, A.V., E.R., L.B., J.K., G.S., B. Boeckx, D.L., F.F. and B. Beuselinck revised the paper. B. Beuselinck performed patient recruitment and clinical data collection of the Leuven cohort, as well as critical data interpretation and paper revision. A.D.G. was the lead investigator of the project, conceptualized the overall project, supervised the research design, and cowrote the paper.

Corresponding authors

Correspondence to Benoit Beuselinck or Abhishek D. Garg .

Ethics declarations

Competing interests.

B. Beuselinck: speaker’s bureau: BMS, Pfizer, MSD, Ipsen; unrestricted research grants: BMS; advisory board: BMS, MSD, Ipsen. A.D.G. received consulting/advisory/lecture honoraria from Boehringer Ingelheim (Germany), Miltenyi Biotec (Germany), Novigenix (Switzerland), SOTIO (Czech Republic) and IsoPlexis (United States) and received R&D project funding from SOTIO. F.F. consults for iOnctura. The other authors declare no competing interests.

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Peer review information.

Nature Medicine thanks A. Ari Hakimi, Jiyang Yu and the other, anonymous, reviewer(s) for their contribution to the peer review of this work. Primary Handling Editor: Ulrike Harjes, in collaboration with the Nature Medicine team.

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Extended data

Extended data fig. 1 positioning and sample availability of leuven rwd cohort..

Positioning of Leuven RWD cohort relative to ICB-treated arms of relevant phase III clinical RCC trials and specific validation cohorts used in this study. Data shown are as per latest report (before August 2023) from the Checkmate025 trial (CM025, nivolumab arm) 80 , Checkmate214 (CM214, ipilimumab-nivolumab arm) 81 , Keynote-426 (KN-426, axitinib-pembrolizumab arm) 82 , Checkmate-9ER (CM9ER, cabozantinib-nivolumab arm) 83 , 84 , CLEAR (lenvatinib-pembrolizumab arm) 85 , 86 , Javelin101 (avelumab-axitinib arm, PFS and ORR as reported in Motzer et al. 20 ), Immotion150 (atezolizumab±bevacizumab arms; data as reported in CRI iAtlas survival data 67 ), Miao et al. (data as reported in CRI iAtlas survival data), Choueiri et al. 38 (data as reported in CRI iAtlas survival data). Colours are indicating the ICB type used in the study, brown represents a mixed cohort of both anti-PD1 and anti-PD1/anti-CTLA4. N numbers represent number of patients. a , Bar chart showing median progression-free survival (mPFS) with 95% confidence interval as error bars. mPFS is indicated above the bar. b , Bar chart showing median overall survival (mOS) with 95% confidence interval as error bars. Cohorts with median OS not reached were omitted (that is, Javelin101, Immotion150). mOS is indicated above the bar. c , Stacked bar chart showing proportion of categories of best response (complete response (CR), partial response (PR), non-responder (NR)). d , Bar chart showing median follow-up time. In case the upper 95% CI value was ‘not reached’, the upper side of the error bar is omitted. e , Flowchart indicating sample availability or loss in the Leuven RWD cohort (created with Biorender.com ).

Source data

Extended data fig. 2 antigenic tams-t cell hub as the core of icb-driven clinical benefit..

a , b , Forest plots showing HR (centre of error bar) with 95%CI (error bar) and two-sided p-values of multivariate [MVA, adjusted for age and IMDC risk group (IMDC adjusted for age only)] Cox proportional hazards models correlating biomarkers with PFS (a) and OS (b) after ICB, with n as indicated on figure for continuous (cont.) and categorical (cat.) variables. P values unadjusted for multiple testing. c , Boxplot comparing expression of biomarkers in responders (R; that is complete/partial response (CR/PR), n  = 32 patients) vs. non-responders (NR; that is stable/progressive disease (SD/PD), n  = 62 patients), with two-sided P-values from Wilcoxon’s tests (uncorrected for multiple testing). d , Stacked bar chart showing categorical biomarkers by responder status (p value as calculated by two-sided Fisher’s Exact test, n patients as indicated on figure). e , Schematic overview of standard bioinformatics biomarker mining approach (created with Biorender.com ). f, g , Forestplots showing HR (centre of error bar) with 95%CI (error bar) and two-sided p-values of UVA Cox proportional hazard regression models correlating deconvoluted immune cell densities (CIBERSORTx) with PFS (f) and OS (g) , n  = 98 independent patient samples. HRs were log-transformed for visual representation. P values unadjusted for multiple testing. h , Boxplots of deconvoluted immune cell fractions by responder status. Two-sided p-values by Wilcoxon’s test, unadjusted for multiple testing. i , Forestplot displaying HR (centre of error bar), 95% CI (error bar) and two-sided p-values as calculated through MVA Cox proportional hazard regression model including age, sex, IMDC risk groups, ICB treatment, Fuhrman grade and sarcomatoid differentiation. Covariates significantly correlated to OS in this MVA model are highlighted in bold. P values uncorrected for multiple testing. For boxplots in c and h , boxes represent median (centre) and first/third quartile (bottom and top, resp.) values; whiskers show most extreme values within 1,5x interquartile range (IQR). Outliers extending beyond 1.5x IQR above/below the median are plotted individually. Non-significant results are abbreviated as ns.

Extended Data Fig. 3 Immune landscape clusters.

a-d , Forest plots displaying HR (centre of error bar), 95%CI (error bar) and two-sided p-values as calculated through either univariate (UVA) or MVA (adjusted for age and IMDC risk group) Cox proportional hazard regression models of whole patients’ cohort and subgroup analysis per treatment type (with n representing number of patients per group), for PFS (a-b) and OS (c-d) . P values are not corrected for multiple testing. e, f , Bar chart representing distribution of Fuhrman tumour grade (e) and sarcomatoid differentiation (f) stratified by ILS clusters. Two-sided p-value as calculated by Fisher’s Exact test. g , Co-expression network based on TCGA KIRC and further based on 95 genes associated with worse ORR, PFS and OS. Only spearman correlations with coefficient > 0.7 are shown. Node size represents betweenness.

Extended Data Fig. 4 Quantitative HLA metrics fail to predict ICB outcome in Leuven cohort.

a , Bar chart representing overall response rate (ORR), showing complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD) and not evaluable (NA), by HLA class I expression (dichotomized by optimal statistical cutoff for overall survival (OS), also for panel b and c). Two-sided p-value as calculated by Fisher Exact test. b-c , Kaplan-Meier curves showing progression-free survival (PFS) (b) and OS (c) stratified by HLA class I expression. d , Bar chart representing ORR by HLA class II expression (dichotomized by optimal statistical cutoff for OS, also for panel e and f). Two-sided p-value as calculated by Fisher Exact test. e, f , Kaplan-Meier curve showing PFS (e) , and OS (f) stratified by HLA class II expression. g , Bar chart representing ORR by HLA heterozygosity (dichotomized by <= 10 vs. 11-12, also for panel h and I). Two-sided p-value as calculated by Fisher Exact test. h, i , Kaplan-Meier curve showing PFS (h) , and OS (i) stratified by HLA heterozygosity. j , Bar chart representing ORR by HLA A*03 allele carrier status. Two-sided p-value as calculated by Fisher Exact test. k-l , Kaplan-Meier curve showing PFS (k) , and OS (l) stratified by HLA A*03 allele carrier status. m , Bar chart representing ORR by HLA evolutionary divergence (HED), dichotomized by highest quartile (also for panel n and o). Two-sided p-value as calculated by Fisher Exact test. n-o , Kaplan-Meier curve showing PFS (n) , and OS (o) stratified by HLA HED. Hazard ratio (HR), 95% confidence interval and two-sided p-values as calculated by Cox proportional hazard models, both univariate (UVA) as well as multivariate (MVA) adjusting for age and IMDC risk group.

Extended Data Fig. 5 HLA promiscuity (HLApr).

a , Bar chart representing overall response rate (ORR) (complete response: CR, partial response: PR, stable disease: SD, progressive disease: PD, not evaluable: NA), stratified by HLApr (dichotomized by optimal statistical cutoff determined on Leuven RWD cohort, also for panel b, c, d, e and f). Two-sided p-value as calculated by Fisher’s Exact test. b, c , Kaplan-Meier curve showing progression-free survival (PFS) (b) and overall survival (OS) (c) stratified by HLApr. d , Bar chart representing ORR stratified by HLApr. Two-sided p-value as calculated by Fisher’s Exact test. e, f , Kaplan-Meier curve showing PFS (e) , and OS (f) stratified by HLApr. Hazard ratio (HR), 95% confidence interval and two-sides p-values as calculated by Cox proportional hazard models, both univariate (UVA) as well as multivariate (MVA) adjusting for age and IMDC risk group. g, h , Bar chart representing distribution of Fuhrman tumour grade (g) and sarcomatoid differentiation (h) stratified by HLA promiscuity. Two-sided p-value as calculated by Fisher’s Exact test. i , Scatter pie plot. Pies represent HLA alleles, with x-axis position representing difference in ORR in patients with HLA allele vs. patients without, and y-axis position representing allele promiscuity value. Pie chart represents types of antigens presented by a particular allele, wherein the size of the pie-chart represents number of HLA-antigen pairs. j , Scatter pie plot. Pies represent HLA alleles, with x-axis position representing HR as calculated by UVA Cox proportional hazard regression model with PFS after start of ICB, and y-axis position representing allele promiscuity value. Pie chart represents types of antigens presented by a particular allele, wherein the size of the pie-chart represents number of HLA-antigen pairs.

Extended Data Fig. 6 Tumour transcriptomic footprint of HLApr LOW .

a , Averaged feature importance (Gini) of top 100 genes in ML-model b , Kaplan-Meier curves of PFS in Leuven cohort, by tLHP. c , ORR stratified by tLHP. Two-sided p-value by Fisher’s Exact test. d, e , Forestplot displaying UVA correlation of tLHP, as continuous signature and by optimal cutoff, with PFS (d) and OS (e) in Leuven cohort. f-i , Forestplots displaying UVA and MVA (adjusted for age/IMDC) correlation of tLHP with PFS (f–g) and OS (h-i) within Leuven cohort treatment subgroups. j , Boxplots of tLHP by IMDC ( n independent patients). Two-sided p-value by Kruskal-Wallis test. k-l , Fuhrman tumour grade (k) and sarcomatoid differentiation (l) stratified by tLHP. Two-sided p-value by Fisher’s Exact test. m , Violinplot showing tLHP expression in cells by disease stage. Two-sided p-value by one-way ANOVA, effect size by Eta-squared. n , Venn diagram showing tLHP and ILS overlap. o , ORR stratified by tLHP. Two-sided p-value by Fisher’s Exact test. p , Forestplot displaying UVA correlation of tLHP with PFS in IMmotion150 subgroups. q , Kaplan-Meier curves showing PFS in Javelin101 sunitinib arm by tLHP. r , Forestplot displaying UVA correlation of tLHP (optimal statistical cutoff in combined cohort) with OS by cancer type in CRI iAtlas. s , Forestplot displaying correlation of tLHP (optimal statistical cutoff in combined cohort) with OS in CRI iAtlas melanoma subgroup. Ipilimumab+pembrolizumab treated patients are not displayed as the statistical model could not be constructed due to insufficient events. For b and q , HR, 95%CI and two-sided p-values by Cox proportional hazard regression (high vs. low) from UVA and MVA [adjusted for age/IMDC (Leuven RWD cohort) or age/sex (Javelin101 cohort)]. For boxplots in j and m , boxes represent median (centre) and first/third quartile (bottom and top, resp.) values; whiskers show extreme values within 1,5x interquartile range (IQR). Outliers extending beyond 1.5x IQR above/below median are plotted individually. Forestplots in d-i, p, r and s show HR, 95%CI (centre, error bar, resp.) and p-values as calculated through Cox proportional hazard regression (high vs. low). P-values unadjusted for multiple testing.

Extended Data Fig. 7 Genomic and transcriptomic characterization of the tLHP signature.

a , Heatmap showing tLHP expression in paired untreated and post-treatment samples. Rows represent individual patients and are hierarchically clustered by complete method. For multiple samples per treatment group, mean tLHP is displayed. b , Boxplots showing tLHP expression in paired untreated and post-treatment samples. P value as calculated with Kruskal-Wallis test. N numbers represent individual samples. c , Violinplots showing tLHP expression in treatment-naïve vs. post-VEGFR-TKI treated samples. Two-sided p-value as calculated by Mann-Whitney U test. d-f , Boxplots showing log10(TMB + 1) in TCGA-KIRC (d) , Javelin101 (e) and IMmotion150 (f) , by tLHP signature (dichotomized by optimal statistical cutoff). Two-sided p-value by Mann-Whitney U test. N numbers represent independent samples. g-i , Heatmap showing gene mutation status by sample in TCGA-KIRC (g) , Javelin101 (h) and IMmotion150 (i) . P values by Fisher’s Exact test are FDR-corrected. j , Boxplot showing TCR richness by tLHP signature (dichotomized by optimal statistical cutoff). Two-sided p-value as calculated by Mann-Whitney U test. N numbers represent individual samples. k, l , Dotplots showing correlation of CIBERSORTx cell types with tLHP signature in Leuven RWD cohort (k) and TCGA-KIRC (l) (Pearson or Spearman correlation depending on normality of cell type estimates. Two-sided p-values are FDR-corrected). m-q , Violinplot showing expression of tLHP signature by responder status for dendritic cells (m) , monocytes (n) , tumour cell type 2 (o) , tumour cell type 1 (p) and regulatory T cells (q) . N numbers represent independent cells. Two-sided p-values were calculated by Kolmogorov-Smirnov test. Effect sizes by Cohen’s D. r , Violin plot showing expression of tLHP signature per cell type ( n  = 152876 independent cells). s-u , Violinplot showing expression of tLHP signature in cells from untreated vs. ICB-treated patients, for all cells (s) , TAM (t) and CD8 + T cells (u) . N numbers represent independent cells. Two-sided p-values were calculated by Kolmogorov-Smirnov test, effect sizes by Cohen’s D. For all boxplots in this figure, boxes represent median (centre) and first/third quartile (bottom and top, resp.) values; whiskers show most extreme values within 1,5x interquartile range (IQR). Outliers extending beyond 1.5x IQR above/below the median are plotted individually.

Extended Data Fig. 8 Antigenicity-relevant TAM-CD8 + T cell interactions associate with ICB benefit in aRCC.

a , Barchart showing relative information flow along pathways between single cells from responder and non-responder patients, as determined through CellChat. Pathways relevant to co-stimulation ( CD86 , CD70 ), immune-inhibitory receptors relevant for the exhaustion state ( BTLA , PDL2 , PDL1 , PVR , TIGIT , CD39 ), T cell activation ( CD226 , CD96 , OX40 , LCK ), cytokine signalling ( XCR , CSF , CXCL ), complement signalling ( CD46 , COMPLEMENT ) and antigen presentation ( MHC-I , MHC-II ) are highlighted in bold. b , Graph representation of correlation (Spearman) per spot between inferred cell population and normalized tLHP expression in ICB non-responder patients. Node colour visualizes graph betweenness centrality, while node size illustrates degree. Edge width represents Spearman correlation coefficient (shown at threshold > 0.48). c , Barplot representing enriched pathways in non-responders using Gene Ontology Biological Processes. Combined scores were used for visual representation (that is natural log of the p-value multiplied by the z-score, where the z-score is the deviation from the expected rank), after manual curation for immune-related pathways. P-values are adjusted for multiple testing with FDR.

Extended Data Fig. 9 Cell type identification through multiplex immunohistochemistry (MILAN).

a , Dotplot showing expression of cell type markers across final annotated cell types. b , Boxplots showing number of interactions of pre-exhausted CD8 + T cells with other cell types. N numbers indicate independent cells per HLApr/ICB-response group. Effect size metric was calculated as Cohen’s D (positive values indicating higher in HLApr LOW /ICB-responders) and two-sided p-values shown are extracted through Kolmogorov-Smirnov tests (multiple testing corrected with false discovery rate with Benjamini-Hochberg method). c , Boxplots showing number of interactions of exhausted CD8 + T cells with other cell types. N numbers indicate independent cells per HLApr/ICB-response group. Effect size metric is shown by Cohen’s D (positive values indicating higher in HLApr LOW /ICB-responders) and two-sided p-values shown are extracted through Kolmogorov-Smirnov tests (multiple testing corrected with false discovery rate). For all boxplots in this figure, boxes represent median (centre) and first/third quartile (bottom and top, resp.) values; whiskers show most extreme values within 1,5x interquartile range (IQR). Outliers extending beyond 1.5x IQR above/below the median were omitted from visualisation.

Extended Data Fig. 10 Immunophenotyping of RENCA tumors.

a , Violin plot of ratio of CD4 + T cells (CD4 + CD3 + ) to tumour area in RENCA tumours after different treatments. P values are from Kruskal-Wallis tests and are not corrected for multiple testing. b , Violin plots of mature classic dendritic cells (DC) type 1 (cDC1) (MHC-II + CD86 + of XCR1 + CD11b + CD11c + ) as percentage of DCs in RENCA tumours after different treatments. P values are from Kruskal-Wallis tests and are not corrected for multiple testing. c , Violin plots of mature classic DC type 2 (cDC2) (MHCII + CD86 + of CD172a + CD11b + CD11c + ) as percentage of DCs in RENCA tumours after different. P values are from Kruskal-Wallis tests and are not corrected for multiple testing. d , Heatmap showing correlation coefficient of Spearman correlation of cell populations with inverse of tumour area (at day 21) in RENCA tumours (columns and rows are clustering using hierarchical clustering with complete method). Displayed values are scaled by treatment type.

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Kinget, L., Naulaerts, S., Govaerts, J. et al. A spatial architecture-embedding HLA signature to predict clinical response to immunotherapy in renal cell carcinoma. Nat Med (2024). https://doi.org/10.1038/s41591-024-02978-9

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Outbreak of Human Trichinellosis — Arizona, Minnesota, and South Dakota, 2022

Weekly / May 23, 2024 / 73(20);456–459

Shama Cash-Goldwasser, MD 1 ; Dustin Ortbahn, MPH 2 ; Muthu Narayan, DO 3 ; Conor Fitzgerald, MPH 4 ; Keila Maldonado 5 ; James Currie, MD 6 ; Anne Straily, DVM 7 ; Sarah Sapp, PhD 7 ; Henry S. Bishop 7 ; Billy Watson, PhD 7 ; Margaret Neja 7 ; Yvonne Qvarnstrom, PhD 7 ; David M. Berman, DO 8 ; Sarah Y. Park, MD 8 ; Kirk Smith, DVM, PhD 9 ; Stacy Holzbauer, DVM 9 ,10 ( View author affiliations )

What is already known about this topic?

Human trichinellosis cases in the United States are rare and are usually acquired through consumption of wild game.

What is added by this report?

Among eight persons who shared a meal that included the meat of a black bear harvested in Canada and frozen for 45 days, six trichinellosis cases were identified. The meat was grilled with vegetables and served rare; two cases occurred in persons who ate only the vegetables. Motile freeze-resistant Trichinella nativa larvae were identified in remaining meat frozen for >15 weeks.

What are the implications for public health practice?

Cooking meat to an internal temperature of ≥165°F (≥74°C) is necessary to kill Trichinella spp. parasites. Trichinella -infected meat can cross-contaminate other foods, and raw meat should be kept and prepared separate from other foods to prevent cross-contamination.

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Trichinellosis is a parasitic zoonotic disease transmitted through the consumption of meat from animals infected with Trichinella spp. nematodes. In North America, human trichinellosis is rare and is most commonly acquired through consumption of wild game meat. In July 2022, a hospitalized patient with suspected trichinellosis was reported to the Minnesota Department of Health. One week before symptom onset, the patient and eight other persons shared a meal that included bear meat that had been frozen for 45 days before being grilled and served rare with vegetables that had been cooked with the meat. Investigation identified six trichinellosis cases, including two in persons who consumed only the vegetables. Motile Trichinella larvae were found in remaining bear meat that had been frozen for >15 weeks. Molecular testing identified larvae from the bear meat as Trichinella nativa , a freeze-resistant species. Persons who consume meat from wild game animals should be aware that that adequate cooking is the only reliable way to kill Trichinella parasites and that infected meat can cross-contaminate other foods.

Investigation and Results

Index patient notification.

In July 2022, the Minnesota Department of Health was notified of a man aged 29 years who was hospitalized with fever, severe myalgias, periorbital edema, eosinophilia, and other laboratory abnormalities ( Table ); health care providers suspected trichinellosis. The patient had sought care for his symptoms, which commenced in early July, four times and had been hospitalized twice over a 17-day period. During his second hospitalization, providers obtained a history of bear meat consumption, and empiric albendazole treatment for probable trichinellosis was initiated. An investigation was launched to confirm the diagnosis, identify additional cases, and ascertain the source of infection to prevent future cases. The index patient’s diagnosis was confirmed by a positive Trichinella immunoglobulin (Ig) G antibody test result.

Potential Exposure Source Identification

Six days before symptom onset in the index patient, he and eight extended family members from three states (Arizona, Minnesota, and South Dakota) had gathered for several days in South Dakota and shared a meal that included kabobs made from the meat of a black bear ( Ursus americanus ), which had been harvested by one of the family members in northern Saskatchewan, Canada in May 2022. The hunting outfitter had recommended freezing the meat to kill parasites. The meat was frozen in a household freezer* for 45 days until being thawed and grilled with vegetables. The meat was initially inadvertently served rare, reportedly because the meat was dark in color, and it was difficult for the family members to visually ascertain the level of doneness. After some of the family members began eating the meat and noticed that it was undercooked, the meat was recooked before being served again. The family reunion concluded before onset of illness in the index patient.

Laboratory Investigation and Case Definition

Public health authorities in Arizona, Minnesota, and South Dakota interviewed eight of the nine persons who had attended the implicated meal. The ninth attendee was a person aged <18 years whose exposure status could not be confirmed; however, that person reportedly remained healthy. Testing of paired acute and convalescent sera for Trichinella IgG antibodies was recommended for the eight exposed persons and was completed for six. Pathogen-agnostic microbial cell-free metagenomic DNA sequencing ( 1 ) was performed on plasma samples from the index patient and one other person who had sought care twice before being hospitalized with fever, myalgias, abdominal pain, periorbital edema, and laboratory abnormalities. Trichinellosis cases were classified according to the 2014 case definition from the Council for State and Territorial Epidemiologists (CSTE), † (i.e., the presence of clinically compatible symptoms in a person who had consumed an epidemiologically implicated meal or meat in which the parasite was demonstrated [probable] or had a positive serologic test result for Trichinella antibodies [confirmed]). Samples of frozen bear meat were obtained from the household freezer and sent to CDC for artificial tissue digestion and microscopic examination for larvae and molecular testing for Trichinella spp.

Additional Case Detection and Exposure Source Confirmation

Among the eight interviewed persons, five consumed the bear meat, and eight consumed the vegetables that had been cooked with it. Six of the eight persons who attended the meal, including four who consumed the bear meat and the vegetables, and two who consumed only the vegetables (but no meat), had symptoms consistent with trichinellosis, and met case criteria (two confirmed and four probable). Patients with trichinellosis ranged in age from 12 to 62 years and lived in three states: Arizona (one), Minnesota (four), and South Dakota (one). All cases were diagnosed in the patients’ state of residence. Three of the six symptomatic persons, two of whom sought care at least twice before being offered treatment, were hospitalized. The three hospitalized persons received trichinellosis-directed treatment with albendazole. § All six symptomatic persons recovered; the nonhospitalized patients did not receive trichinellosis-directed treatment because their symptoms had resolved with supportive care only, and the benefit of treatment after larval invasion of muscle is unclear ( 2 ). Six persons submitted a serum sample, each collected within 4 weeks of symptom onset; two specimens tested positive for Trichinella IgG antibodies by enzyme-linked immunosorbent assay. Two persons submitted a plasma sample for microbial cell-free DNA sequencing during hospitalization for trichinellosis-compatible symptoms, and both plasma samples tested positive for Trichinella spp. DNA. Microscopy identified motile Trichinella larvae (>800 larvae/g) in samples of bear meat that had been frozen for 110 days in a household freezer ( Figure ). Real-time multiplex polymerase chain reaction testing ( 3 ) of the bear meat was positive for T. nativa and whole genome sequencing identified mitochondrial sequences 100% identical to T. nativa.

Public Health Response

The family member who harvested the bear and provided meat samples for testing was advised to discard any remaining meat. All identified trichinellosis cases were reported to appropriate state health departments and to CDC. CDC notified the Public Health Agency of Canada of the outbreak and the confirmed source of infection. This activity was reviewed by CDC, deemed not research, and was conducted consistent with applicable federal law and CDC policy. ¶

Trichinellosis is rarely reported in the United States. As a result of changes in pork production practices from historical norms that fostered transmission, most cases reported in recent years are attributed to consumption of meat from wild game ( 4 ). During January 2016–December 2022, seven U.S. trichinellosis outbreaks, including 35 probable and confirmed cases, were reported to CDC; bear meat was the suspected or confirmed source of infection in the majority of those outbreaks (CDC, unpublished data, 2022). Estimates of Trichinella infection prevalence among wild animal host species vary widely. A Trichinella infection prevalence range of at least 1% to 24% among black bears in Canada and Alaska has been reported, and even higher prevalences of Trichinella infection are reported among species of predators that are strict carnivores (e.g., polar bear, wolverine, and cougar) ( 5 ). The frequency with which black bear meat is the implicated source of human infection might be driven by hunting practices, ecological factors, and the relatively high parasite density observed in the muscle of infected black bears compared with that of other species ( 6 , 7 ).

Because symptoms of trichinellosis are typically nonspecific, diagnosis of infection requires a high index of suspicion; however, periorbital edema and certain laboratory abnormalities (e.g., eosinophilia and elevated creatine kinase levels) can provide etiologic clues. In this outbreak, two of the hospitalized patients sought care multiple times before receiving a diagnosis. Four of the six patients met clinical and epidemiologic criteria and thus were considered probable cases. Laboratory confirmation can be challenging because of the limited sensitivity of antibody testing early in illness ( 8 ); in this investigation, acute Trichinella IgG test results were positive in only two of six tested patient specimens. The clinical utility of trichinellosis test results obtained after acute illness is limited, and historically, public health investigators have had difficulty obtaining convalescent serum samples from persons who have recovered. Laboratory criteria in the current CSTE trichinellosis case definition do not include nucleic acid testing of human specimens. The sensitivity of such assays to detect Trichinella DNA in blood is uncharacterized; however, plasma samples from both patients tested by metagenomic sequencing ( 1 ) yielded positive results for Trichinella DNA. As demonstrated in this outbreak, pathogen-agnostic molecular assays can be useful for detection of rare diseases when standard workup is unrevealing and if other diagnostic tests lack sensitivity.

Implications for Public Health Practice

Although freezing kills Trichinella species commonly implicated in pork-associated outbreaks, freeze-resistant Trichinella species, including T. nativa and the T6 genotype ( 9 ), predominate in Arctic and sub-Arctic regions ( 6 ). Larval motility was observed in bear meat that had been frozen for nearly 4 months (110 days). Persons who consume game meat, especially that harvested in northern latitudes, should be informed that adequate cooking is the only reliable way to kill Trichinella parasites. Cooking wild game meat to an internal temperature of ≥165°F (≥74°C) is recommended by public health authorities**; temperatures should be verified with a meat thermometer. As demonstrated in this outbreak, the color of meat is not a good indicator of cooking adequacy. Safe handling of raw meat (i.e., separating raw or undercooked meat and its juices from other foods) is recommended to prevent trichinellosis; this investigation and previous investigations suggest that Trichinella -infected meat can cross-contaminate other foods ( 10 ). Government and private entities that oversee and organize hunting should educate hunters about these risks and effective preventative measures.

Acknowledgments

The persons affected by this outbreak; Lauren Ahart, Sue Montgomery, Parasitic Diseases Branch, CDC.

Corresponding author: Shama Cash-Goldwasser, [email protected] .

1 Epidemic Intelligence Service, CDC; 2 South Dakota Department of Health; 3 University of Minnesota, Minneapolis, Minnesota; 4 Arizona Department of Health Services; 5 Maricopa County Department of Public Health, Phoenix, Arizona; 6 Lakeview Clinic, Waconia, Minnesota; 7 Division of Parasitic Diseases and Malaria, Center for Global Health, CDC; 8 Medical Affairs, Karius, Inc., Redwood City, California; 9 Minnesota Department of Health; 10 Division of State and Local Readiness, Center for Preparedness and Response, CDC.

All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. David M. Berman reports that he is a paid laboratory medical consultant for Precision Health Solutions and reports ownership of company shares in Karius, Inc. No other potential conflicts of interest were disclosed.

* The temperature of the freezer is not known.

† https://ndc.services.cdc.gov/case-definitions/trichinellosis-2014/

§ https://www.cdc.gov/trichinellosis/hcp/clinical-care/index.html

¶ 45 C.F.R. part 46, 21 C.F.R. part 56; 42 U.S.C. Sect. 241(d); 5 U.S.C. Sect. 552a; 44 U.S.C. Sect. 3501 et seq.

** https://www.cdc.gov/trichinellosis/prevention/index.html

• Blauwkamp TA, Thair S, Rosen MJ, et al. Analytical and clinical validation of a microbial cell-free DNA sequencing test for infectious disease. Nat Microbiol 2019;4:663–74. https://doi.org/10.1038/s41564-018-0349-6 PMID:30742071
• Pozio E, Sacchini D, Sacchi L, Tamburrini A, Alberici F. Failure of mebendazole in the treatment of humans with Trichinella spiralis infection at the stage of encapsulating larvae. Clin Infect Dis 2001;32:638–42. https://doi.org/10.1086/318707 PMID:11181129
• Almeida M, Bishop H, Nascimento FS, Mathison B, Bradbury RS, Silva AD. Multiplex TaqMan qPCR assay for specific identification of encapsulated Trichinella species prevalent in North America. Mem Inst Oswaldo Cruz 2018;113:e180305. https://doi.org/10.1590/0074-02760180305 PMID:30379199
• Wilson NO, Hall RL, Montgomery SP, Jones JL. Trichinellosis surveillance—United States, 2008-2012. MMWR Surveill Summ 2015;64(No. SS-1):1–8. PMID:25590865
• Oksanen A, Kärssin A, Berg RPKD, et al. Epidemiology of Trichinella in the Arctic and subarctic: a review. Food Waterborne Parasitol 2022;28:e00167. https://doi.org/10.1016/j.fawpar.2022.e00167 PMID:35812081
• Gajadhar AA, Forbes LB. A 10-year wildlife survey of 15 species of Canadian carnivores identifies new hosts or geographic locations for Trichinella genotypes T2, T4, T5, and T6. Vet Parasitol 2010;168:78–83. https://doi.org/10.1016/j.vetpar.2009.10.012 PMID:19926223
• Harms NJ, Larivee M, Scandrett B, Russell D. High prevalence and intensity of Trichinella infection in Yukon American Black ( Ursus americanus ) and Grizzly ( Ursus arctos ) bears. J Wildl Dis 2021;57:429–33. https://doi.org/10.7589/JWD-D-20-00135 PMID:33822166
• Yang Y, Cai YN, Tong MW, et al. Serological tools for detection of Trichinella infection in animals and humans. One Health 2016;2:25–30. https://doi.org/10.1016/j.onehlt.2015.11.005 PMID:28616474
• Pozio E. Adaptation of Trichinella spp. for survival in cold climates. Food Waterborne Parasitol 2016;4:4–12. https://doi.org/10.1016/j.fawpar.2016.07.001
• Hall RL, Lindsay A, Hammond C, et al. Outbreak of human trichinellosis in Northern California caused by Trichinella murrelli . Am J Trop Med Hyg 2012;87:297–302. https://doi.org/10.4269/ajtmh.2012.12-0075 PMID:22855761

Abbreviations: eos = eosinophils; F = female; M = male; NA = not applicable; ND = not done; WBC = white blood cell. * Initial results are from hospitalization during which trichinellosis was suspected. Reference ranges varied among different laboratories that conducted testing. † Reference range = 4–88. § Reference range = 39–208. ¶ Consumed vegetables that were cooked and served with the bear meat. ** Reference range = 39–308.

FIGURE . Microscopic examination of encapsulated larvae in a direct black bear meat muscle squash prep (A), larvae liberated from artificially digested bear meat (B), and motile larvae viewed with differential interference contrast microscopy (C and D)* from black bear meat suspected as the source of an outbreak of human Trichinella nativa infections — Arizona, Minnesota, and South Dakota, 2022

Photos/Division of Parasitic Diseases and Malaria, Center for Global Health, CDC

* Scale bars = 100 µ m.

Suggested citation for this article: Cash-Goldwasser S, Ortbahn D, Narayan M, et al. Outbreak of Human Trichinellosis — Arizona, Minnesota, and South Dakota, 2022. MMWR Morb Mortal Wkly Rep 2024;73:456–459. DOI: http://dx.doi.org/10.15585/mmwr.mm7320a2 .

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Sand in Newport Beach was replenished in 2023. (Photo/iStock)

Beach erosion will make Southern California coastal living five times more expensive by 2050, USC study predicts

The region’s sandy coastlines are vanishing at an alarming rate. It’s a warning sign for coastal communities worldwide, USC research suggests.

Rising sea levels and urban development are accelerating coastal erosion at an alarming rate in Southern California with significant ripple effects on the region’s economy, a USC study reveals.

The study, published in Communications Earth & Environment , predicts that Southern California’s coastal living costs will surge fivefold by 2050 as a direct result of beach erosion. This erosion will require more frequent and costly beach nourishment projects to maintain the state’s treasured shorelines, consequently driving up the cost of living along the coast.

“Our study presents compelling evidence of the rapid deterioration of Southern California’s coastal landscapes,” said Essam Heggy , a geoscientist in the Ming Hsieh Department of Electrical and Computer Engineering/Electrophysics at the USC Viterbi School of Engineering and the study’s corresponding author.

“The challenges facing Southern California mirror a growing threat shared by coastal communities worldwide. The environmental and economic implications of coastal erosion reach far beyond California’s shores and demand interdisciplinary, global solutions,” he said.

Coastal erosion: Cost of living sure to surge as sandy beaches disappear

To predict future changes along California’s sandy coastlines, the researchers focused on the Gulf of Santa Catalina, which stretches over 150 miles from the Palos Verdes Peninsula in Los Angeles County to the northern tip of Baja California in Mexico.

They used a combination of historical and recent satellite images as well as advanced algorithms to analyze coastline movement and predict future erosion based on different trends and environmental factors.

The study predicts a tripling of erosion rates by 2050, increasing from an average of 1.45 meters per year to 3.18 meters by 2100. Consequently, the annual sand requirement for beach nourishment could triple by 2050, with costs rising fivefold due to the global increase in sand prices. This will exacerbate economic and logistical pressures on coastal communities.

Beach nourishment is adding sand to an eroded beach to rebuild it and create a wider barrier against waves and storms.

“Our investigation suggests that coastal problems start inland due to the rapid growth of cities along the coast, which compromise inland sediment replenishment of sandy beaches,” said Heggy, whose research focuses on understanding water evolution in Earth’s arid environments.

“As our beaches shrink, the cost of maintaining them will rise. Finding innovative solutions is key to securing a sustainable future for our shores and local economies,” he said.

Coastal erosion in California: A case study for a global problem

Coastal cities in Southern California and those in North Africa bordering the Mediterranean Sea face a common challenge: a semi-arid climate year-round coupled with the growing threats of rising sea levels and eroding shorelines.

A significant portion of Earth’s landmass, roughly 41%, falls under arid or semi-arid classifications, and these areas support over a third of the global population.

To understand this global challenge, the researchers focused on two specific locations: Corona del Mar in Orange County, Calif. — an example of the typical Southern California coastline — and Hammamet North Beach in Tunisia. Both are densely populated and share similar climates, prone to increasing droughts, flash floods and unpredictable rainfall patterns. These characteristics mirror the challenges faced by countless coastal communities worldwide.

The findings showed that the average rate of shoreline retreat in these areas varies. In Southern California, beaches are receding between 0.75 and 1.24 meters per year. In Hammamet North Beach, the retreat rate ranges from 0.21 to about 4.49 meters annually.

“While beach nourishment can temporarily combat erosion, however, it presents significant challenges for developing countries,” said Oula Amrouni, a sedimentologist at the National Institute of Marine Sciences and Technologies at the University of Carthage, Tunis, Tunisia, and one of the study’s co-authors. “The high cost of acquiring the right sand, with the specific grain size, quality and composition, and the technical complexity of extracting and laying it are major hurdles. Additionally, worsening erosion in previously stable areas compels more frequent nourishment projects, straining already limited budgets and leading to unplanned expenditures for many communities.”

About the study: Co-authors of the study include Oula Amrouni and Abderraouf Hzami of the National Institute of Marine Sciences and Technologies at the University of Carthage, Tunis, Tunisia.

This research is supported by the Arid Climates and Water Research Center at USC under contract from the NASA Jet Propulsion Laboratory (AWD#00630), the USC Zumberge Research and Innovation Fund, and the USC Sea Grant.

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