cima may case study results

• Course Finder
• Career Advice
• PQ Awards 2022
• PQ Awards 2021
• PQ Awards 2020
• PQ Magazine
• NQ Magazine

Those CIMA May case study pass rates

The May 2023 CIMA case study exam pass rates are out, and it was a mixed bag of results.

The operational case study pass rate dipped 4 percentage points to 64% (when compared to February 2023). It hasn’t been this low since May 2022, when the pass rate was 62%.

The management case study pass rate also fell to 67% in May (it was 72% in February). We went back to February 2021 pass rates and this is the lowest it has been for over 10 exam sittings!

The good news was the Strategic case study, which saw the pass rate rise to 62%. The Strategic case study has the most volatile pass rates, which have been as high as 72% (February 2022) and as low as 56% (February 2023).

Stephen Flatman, Vice President, Examinations – Management Accounting, told PQ magazine: “I am delighted to extend my warmest congratulations to the candidates for their success in the May case study exams. They have demonstrated commitment to their professional development, dedication and hard work.

The business simulation exams are designed to be challenging. They test candidates on the application of business practice and a deep knowledge of all aspects of accounting and finance. That way, employers all around the world can be confident that prospective employees who have attained the prestigious Chartered Global Management Accountant (CGMA) designation will be a great asset to their organisations.”

CIMA May 2023 Case Study exam pass rates: OCS 64%; MCS 67%; SCS 62%

Copyright © 2024 PQ Publishing.

Privacy Overview

0800 048 7804   |   [email protected]

About Us Testimonials Exam Dates About CIMA Quick Purchase Basket Help Contact Us studyHUB Home

CIMA Case Study Useful Resources

Exam resources for the current case study exam – May & August 2024

In this section, you can find the pre-seen documents for the current CIMA case study sitting, as well as a link to Astranti’s free pre-seen analysis sample materials on YouTube. You can also find links to purchase Astranti’s full set of pre-seen analysis materials.

New materials will be added as pre-seen documents and examiner reports are published by CIMA. Pre-seen documents are published around six weeks before the exam, and interim examiner’s reports are published around the November and May sitting results days. Check the exam dates page to see when this is due for every level.

EXPLORE OUR PRE-SEEN ANALYSIS MATERIALS

Every sitting, our case study tutors get their heads together to complete a full analysis of the pre-seen company, its industry, how the theory from your objective test exams can be applied and which issues are most likely to appear in the exam.

Find out more about our pre-seen analysis materials and watch sample videos using the links below:

Exam resources from the last CIMA case study – November 2023 & February 2024

In this section you can access the pre-seen documents and interim examiner’s reports for the previous case study sitting, as well as links to our pre-seen analysis video archive playlist on YouTube. The full examiner’s reports are usually published around the same time as results day for the second set of exams, so make sure to check back regularly to see the full reports once they become available.

Exam resources from previous CIMA case studies

In this section you can access the pre-seen documents and examiner’s reports for all previous CIMA case study sittings taken under the 2019 syllabus. All Astranti pre-seen video samples for these sittings is available using the YouTube archive links above.

View OCS archive

Watch past pre-seen videos: OCS Pre-seen Video Archive

May-August 2023: Pre-seen Document Examiner’s Report

November 2022-February 2023: Pre-seen Document Examiner’s Report

May-August 2022: Pre-seen Document Examiner’s Report

November 2021-February 2022: Pre-seen Document Examiner’s Report

May-August 2021: Pre-seen Document Examiner’s Report

November 2020-February 2021 Pre-seen Document Examiner’s Report

May-August 2020: Pre-seen Document Examiner’s Report

February 2020: Pre-seen Document Examiner’s Report

November 2019: Pre-seen Document Examiner’s Interim Report

View MCS archive

Watch past pre-seen videos: MCS Pre-seen Video Archive

View SCS archive

Watch past pre-seen videos: SCS Pre-seen Video Archive

Additional CIMA exam resources

Subscribe to our channel on YouTube…

In addition to a full set of sample video materials for every new CIMA case study pre-seen, Astranti also produce regular video guides on writing stronger answers that the examiner can give more marks. Visit our full playlist on YouTube using the link below to discover our full set of free video guides to improving your exam technique and earning more marks.

Access the CIMA certificate-level examiner guides…

The CIMA Certificate examiner’s guides here will help you to gain an understanding of what is required to succeed in the CIMA certificate level exams.

Each paper assesses a different fundamental area of management accounting and as such requires a slightly different approach. 

The examiner’s guides will give you:

• A better understanding of the syllabus
• Advice on your study options and planning your studies
• Guidance on your exam assessment including exam techniques
• Information on booking your assessment, your exam day and your results

To qualify for the pass guarantee you need to ensure you complete ALL of the following steps. Failure to complete all of these steps will mean you will not qualify.

View & Print:

1. Click the “View + Print” link to view the study text.

2.  Wait  for all of the pages to load , this can sometimes take a couple of minutes depending on the size of the document (scroll to the last page to ensure that every page loads).

3.  Click  on the print icon within the document viewer (NOT the print icon in the browser menu).

4.  Follow  the steps to print.

Other things to try:

Please try an alternative browser.   Google Chrome and Firefox are recommended, but other  browsers may also work.  Updating your browser to the latest version can help your document load more quickly.

If you are using Windows XP and a version of Internet Explorer older than 9, we cannot guarantee  that printing will be possible. We recommend obtaining access to a computer with at least Windows 7.

Updating to the latest  version of flash can help to resolve some people’s printing issues ( download the latest version of flash .)

If your document fails to load, try clearing your cache and browser history. If your documents still do not load it may be due to the network you are on. We suggest trying to print on a different network.

If you still cannot print your document we suggest using a different computer and/or printer in case you are experiencing a hardware issue.

This Content is Locked

To access this resource you will need to purchase it, or join our complete course. Visit our quick purchase page to get the resources you need.

• You are here:
• Home »
• Blog »
• CIMA Exam »

CIMA Exam Results and a Look at the Grading Mechanism

• By Stephanie Ng
• / 3 COMMENTS

Eager to find out when you will get the CIMA exam results, and how to interpret the performance report?

CIMA Exam Results for Objective Tests

Since the implementation of the new format, it is the easiest and fastest to get the CIMA objective test exam results — you get a “pass” or “fall” grade immediately after the computerized exam.

After 48 hours, you will receive an email, confirming that CIMA exam results breakdown is available in the MYCIMA portal.

CIMA Exam Results Breakdown

The results are shown in a table format, listing the subject areas in the objective test.

Each subject area is marked “proficient” or “not proficient”, with more detailed comments on how you can improve.

Here is a sample showing the candidate getting a “not proficient” in Financial Reporting:

Image courtesy of thecimastudent.com

If you’d like to have a glimpse at how the full performance report looks like, check out this official video from the CIMA:

A Note on CIMA Exam Pass Mark

The CIMA states that you need a 70% accuracy to pass each objective test. At the same time, they tell you the CIMA exam pass mark is 100.

Please understand that you are given a scaled score ranging from 0 to 150. The emphasis is that this score is scaled, meaning that you cannot figure out your percentage accuracy by a straight formula. In fact, if you try to divide 100 by 150, you get 66.7% instead of 70%.

The scaling is a way for CIMA to balance the more difficult questions with the easier questions . The system weighs difficult questions slightly more, such that students who got a few more difficult questions wrong would still score the same as those getting more easier questions right.

CIMA Case Study Results

The questions in case study exams are more complex. Human graders instead of computers mark this exam, and therefore, we need to wait for approximately 5 weeks after the end of the testing window to get the results.

Similar to the objective test, the performance report is available on the MyCIMA portal, and is presented in the form of a table. We will see “Strong”, “Moderate” or “Fail” in each of the 5 competencies.

In this example, the table is showing “Moderate” under technical skills is marked “Moderate”, with details on areas of improvement:

For those who would like to know the technical side of grading, here is a detailed explanation by the CIMA:

A Note on CIMA Case Study Pass Mark

The pass mark for case study is 80, out of a scaled score of 0 to 150. The candidate must also score a “Moderate” or “Strong” across all competencies in order to pass the case study exam. This is to ensure that the candidate is not weak in a particular area and that he/she is “business ready”.

Even if you pass, take a look at the performance report for rooms of improvement. This will only help you in the next CIMA case study exam.

Is This helpful?

I hope the discussion on CIMA exam grading and results is helpful in preparing psychologically for this exam. If you have any questions, please drop a note in the comment section. Thank you and good luck!

For Your Further Reading

• Frequently asked questions on the CIMA exam
• CIMA exam historical pass rates

About the Author Stephanie Ng

I am the author of How to Pass The CPA Exam (published by Wiley) and the publisher of this and several accounting professional exam prep sites.

Related Posts

Approved CIMA Exam Calculator (+ My Recommendation)

CIMA Practice Exams and Online Course: A Comparison

How Hard is the CIMA Exam? 3 Ways to Find Out the Difficulty

Popular posts

Cma exam results: cma exam release dates for 2024, how to become a cma: the cma certification process, cma requirements: how to meet the cma exam requirements & determine your eligibility, best cma exam review courses & cma exam prep 2024.

Exam pass rates

Certificate in Business Accounting, CIMA’s CGMA® Professional Qualification Objective Test and Case Study Exam pass rates

Every purchase you make from the AICPA & CIMA is safe and secure. We also guarantee 100% customer satisfaction on most of our products. If you’re not satisfied with your purchase, please contact us.

To start the return process, please contact us first. View all products eligible for refunds .

This site is brought to you by the Association of International Certified Professional Accountants, the global voice of the accounting and finance profession, founded by the American Institute of CPAs and The Chartered Institute of Management Accountants.

CA Do Not Sell or Share My Personal Information

• FI Learn Login

CIMA Dates & Deadlines

Whether you’re a student preparing for exams, a professional planning to start studying CIMA/CGMA, or an employer supporting your staff’s CIMA/CGMA journey, this guide aims to provide you with up-to-date information on exam registration deadlines, exam dates, course dates, and other important milestones.

• 18 April 2024

CIMA students will be familiar with the complexities of the CIMA calendar. After Certificate level, there are 3 Objective Test (OT) exams at each level, followed by a Case Study Exam, each with its own deadlines at key points in the exam sitting cycle. A missed course start date or exam entry deadline can throw even the most meticulously planned study schedule off track.  Use this guide to stay on track towards achieving your goals, plan ahead and keep up to date with important deadlines.

Objective Tests (OT’s)

📅Course start dates:   All year round!

Unlike Case Study exams, exams for Objective Test modules do not follow an exam sitting cycle. Therefore, you can book ObjectiveTest exams at various dates all year round. Likewise, you’ll find that FI courses for Objective Test exams start all year round, online and in local study centres. You can also study on-demand via FI Online . Planning and preparation are key to getting the result you want on the big day. Find tips on preparing for your exam below:

🔍 10 Exam preparation mistakes to avoid 🔍 Dealing with exam nerves

May 2024 Case Study Exam Sitting

📖 May Case Study course dates:  06th April – 25th April 2024

Courses for the May Case Study exams start in April and will run throughout the month. Spaces are limited, so we would recommend booking as soon as possible to secure your place. Can’t make these dates?  Study on-demand with FI Online instead.

🔍 What happens on a Case Study course?

🔔 May E xam entry deadlines:

Operational: 23/04/24 | Management: 30/04/24 | Strategic: 08/05/24

📅 May   Exam Week:

Operational: 0 8-10 May  | Management: 15-17 May   | Strategic: 22-24 May

Planning and preparation are key to getting the result you want on the big day. Find tips on preparing for your exam below:

🔍 10 Exam preparation mistakes to avoid

🔍 Dealing with exam nerves

🔍 Case Study Exams: What’s the examiner looking for?

📅 Exam Results Day:  

Operational Level: 27/06/24 | Management Level: 04/07/24 | Strategic Level: 11/07/24

August 2024 Case Study Exam Sitting

📖 August Case Study course dates:  03rd July – 25th July 2024

Courses for the August Case Study exams start in July and will run throughout the month. Spaces are limited, so we would recommend booking as soon as possible to secure your place. Can’t make these dates?  Study on-demand with FI Online instead.

🔔 August Exa m entry deadlines:

Operational: 23/07/24 | Management: 30/07/24 | Strategic: 06/08/24

📅 August   Exam Week:

Operational: 07-09 August  | Management: 14-16 August   | Strategic: 21-23 August

Operational Level: 26/09/24 | Management Level: 03/10/24 | Strategic Level: 10/10/24

November 2024 Case Study Exam Sitting

📖 November Case Study course dates:  27th September – 24th October 2024

Courses for the November Case Study exams start in September and will run throughout October. Spaces are limited, so we would recommend booking as soon as possible to secure your place. Can’t make these dates?  Study on-demand with FI Online instead.

🔔 November Exa m entry deadlines:

Operational: 22/10/24 | Management: 29 /10/24 | Strategic: 05/11/24

📅  November Exam Week:

Operational: 06-08 November  | Management: 13-15 November   | Strategic: 20-22 November

Operational Level: 02 /01/25 | Management Level: 09/01/25 | Strategic Level: 09 /01/25

Quick links: Studying CIMA at FI | Book CIMA courses now | Study Centres | Online Courses

We wish you the best of luck with your studies. Remember to balance your study time with some fun and relaxation too.

Considering starting your ACCA studies? Find more useful articles below:

Experience a CIMA online course before you buy it.

Guidance to help you add structure to your CIMA studies.

SHARE THIS ARTICLE

• Privacy Overview
• Necessary Cookies
• Analytics Cookies
• Additional Cookies
• Cookie Policy

This website uses cookies to enable the proper functioning of the shopping basket features, to analyse site performance in order to improve your experience on our website, to collect data for ads personalisation and measurement and to share with third-party tools. For more information, please see our  Cookie & Privacy Policy .

This website uses cookies to enable proper functioning of shopping cart features, to analyse site performance and to share with third-party social media and advertising partners for marketing and remarketing purposes.

If you disable these cookies the Book Now section will not be able to function properly, and you will need to enableor disable cookies again every time you visit the site.

We use Google Analytics to collect anonymous information such as the number of visitors to the site, and the most popular pages. Keeping these cookies enabled helps us to improve our website and your experience of using it.

Please enable Strictly Necessary Cookies first so that we can save your preferences!

We also use cookies to share information about your use of the site with our social media and advertising partners - including Google, Facebook and LinkedIn - who may combine it with other information you’ve provided to them or that they have collected from your use of their services. By placing cookies on your device, third-party vendors can also show you adverts on websites across the internet, based on your past visits and use of our site. Cookies used for these purposes have expiry dates ranging from 1 day to 2 years. We may also use cookies to follow-up with you by email or other channels if you have abandoned your basket before checking out in order to see if we can assist with any problems you might have had in making your booking.

Read more about our Privacy & Cookie Policy

CIMA Exam Dates

Here we present the CIMA exam dates for 2022/2023 in an easy-to-understand way. Accelerate your CIMA journey with award-winning courses from VIVA.

It's always a good idea to plan ahead as early as possible, and especially so when studying for a challenging professional qualification like CIMA. However, the official CIMA exam dates can be a little tricky to find and navigate.

So we have created a simple guide for you here, where you can browse all the important CIMA exam dates and details over the coming 12 months.

A few provisional points before we get to the exam dates themselves:

• Note that there are only set exam dates for the CIMA Case Study exams. The Objective Test exams can be taken at any point throughout the year, contingent on opening dates and hours for official exam centres
• Since 2019, CIMA has changed slightly the structure of the Case Study exams. Previously there was a new pre-seen released for each exam window (i.e. one for February, one for May, one for August etc). Now, one pre-seen covers two exam windows. So the pre-seen released ahead of the November exam also covers the following February's exam. And the pre-seen released for the May exam also applies to the following August's exam.
• Don't forget to register for your CIMA Case Study exam! Be very aware of the deadlines for registering for each CIMA exam window (see below). Students often forget this one.

1. CIMA Exam Dates 2022/2023

Below you can find a simple table with the exam dates for each window over the next 12 months or so. These are the dates when you can actually sit the exams. If you need to locate an official CIMA exam centre, you can find more information here.

Note that these date ranges are inclusive. So for example, it says "10-12 November", that means you can sit the exam on the 10th, on the 11th, or on the 12th.

Typically the dates fall on a Wednesday, Thursday and Friday. But be sure to double-check, taking into account your local time-zone and how this might affect you.

2. Pre-seen Release Dates

Several weeks before each Case Study exam takes place, CIMA releases the pre-seen document to students. The pre-seen is the document that introduces you to the company and industry that is the focus of the case study. It includes lots of important information that you will be expected to use on the day of your exam to help write your answers.

Usually, you can find the pre-seen document available for download on CIMA's website on the official pre-seen release date (listed below). You can find the most recent pre-seen available for download here.

3. Exam Entry Closing Dates

As mentioned above, this is one that students often forget, or forget to check ahead of time! Be sure to register as early as you can.

Of course, it's important to bear in mind that you cannot register for your Case Study exam until you have officially passed all of the corresponding Objective Test exams at that level (this doesn't necessarily apply to all students, as some students may have been granted exemptions from certain Objective Test exams, e.g. Gateway students for the MCS).

If you are sitting all of the Objective Test exams for that level, you need to factor this into your planning. "Can I realistically have all my Objective Test exams passed by the closing date for the Case Study exam?". An important question to consider!

4. Dates when Exam Results are Released

Important to know the exam results dates, if only to ensure that you time set aside to distract yourself from the nerves/excitement/anticipation in the preceding hours!

Students often ask "but at what time does CIMA release the exam results!?" I'm afraid to say that this one is a bit unpredictable! Sometimes it's literally within seconds of the clock striking midnight (UK time) on the date in question. Other times, students need to wait until later in the morning or even early afternoon to get their results.

That's ultimately at CIMA's discretion, and unfortunately VIVA has no inside knowledge on that particular aspect of CIMA! (... although we're certain we have plenty of insight on others!).

You will typically find your CIMA exam results on your CIMA account, on the CIMA website. So make sure you have your log in credentials ready to go, and your finger hovering over the refresh button...

5. Exam booked? Where to start studying

Now this is going to sound biased, but... VIVA is the place to start! But we say it with good reason. VIVA is an award-winning tuition provider , a certified CIMA learning partner, and a pioneer in terms of delivering premium online learning at a fraction of the cost of traditional institutions.

But don't worry, we're not trying to just sell, sell, sell! You can start learning for your Case Study exam entirely for free , immediately.

We have 2 hours of free pre-seen analysis for every case study exam/window. You can find these free lectures on our YouTube channel here.

We also have tonnes of useful free exam guides and articles in our Knowledge Centre . For example, this extensive guide on how to write a Case Study exam answer here.

If you're impressed by this and want to really nail your exam, then you can explore our award-winning online courses here.

We hope you found this guide useful. If you have any questions, feel free to drop us a message in our chatbox to the bottom right of your screen (or email us at [email protected]).

A huge good luck from the entire VIVA team!

Like to explore how VIVA can help you with your CIMA studies?

Be the first to find out when we release new CIMA resources.

Related resources

Other resources that may be of interest to you.

• Need to report a claim?

May 16, 2024

Case Study: A Wrongful Birth Case

Reprinted from The Scope: Medical Edition, Issue 16 (First Quarter 2024)

By Mirsade Markovic, an attorney with the MLMIC Legal Department, and Katherine Harth, Assistant Vice President of Claims with MLMIC

In this case, a 25-year-old female alleged that, during her pregnancy, she was not fully informed that her infant would suffer birth defects, and, had she known, she would have opted to terminate the pregnancy.

Treatment The patient was initially seen in the emergency department (ED) of a MLMIC-insured hospital with complaints of discomfort when urinating and a potential pregnancy, as a home test had been positive. A serum pregnancy test was positive, but a transabdominal sonogram did not detect the pregnancy. A pelvic exam and transvaginal ultrasound were offered, but the patient refused.

She was diagnosed with a urinary tract infection and “early pregnancy” and advised to follow up with her primary medical physician, as well as an obstetrician.

Two months later, the patient was seen by a MLMIC-insured OB-GYN for a confirmed pregnancy and was referred for an ultrasound. The ultrasound was performed and interpreted by a MLMIC-insured radiologist, who confirmed a gestational age of 13 weeks and four days. There was no mention of an abnormality on the report or discussions with the mother reporting any issues with the fetus, including an omphalocele.

The following day, the patient presented to the hospital’s ED complaining of heavy bleeding the previous day. She was seen by a MLMIC-insured nurse practitioner, and the physical and pelvic exams were normal. An ultrasound was performed, and the report by another MLMIC-insured radiologist stated, “single intrauterine gestation with estimated gestational age of 13 weeks and two days with a fetal heart [rate] of 145 bpm” and “an ovoid soft tissue mass-like structure along the anterior abdominal wall, possibly an omphalocele versus physiologic herniation.”

This was the first indication of an abnormality with the fetus. However, on the patient’s next visit to the OB-GYN, while there was no mention of this negative ultrasound or any discussion with the patient, the patient was referred for a Level 2 sonogram. The reason stated for this study was “presumed omphalocele on prior exam.”

This ultrasound was not done until four weeks later at a gestational age between 19 and 20 weeks. It was interpreted by another MLMIC-insured radiologist, who confirmed the omphalocele along with a left-sided diaphragmatic hernia. Close clinical observation and consultation were suggested. However, although the patient was seen by her obstetrician on two more occasions, the ultrasound findings were not conveyed to her on either visit.

At 27 weeks and one day, the patient requested a 3D ultrasound as a keepsake of her pregnancy. She was told by the radiology office at that point that this could not be done, and they advised her to contact her OB-GYN. She was seen by this doctor that day, and the issues with the fetus were discussed. At that point, her physician referred her to a perinatology office.

The patient was seen at the perinatology center at 29 weeks, and a Level 2 ultrasound confirmed “the presence of a large omphalocele with a portion of the fetal liver, diaphragmatic hernia and significant displacement of fetal heart and stomach.” Chromosomal studies were normal, but the patient was advised of the complexity of the situation and that the infant would require surgery.

The pregnancy continued to term, and the infant was delivered via C-section at 39 weeks. The infant was transferred to the NICU at another hospital and remained there for seven months, requiring multiple surgeries and procedures including three hernia repair surgeries, the placement of a gastrostomy tube and surgery to correct gastroesophageal reflux disease. The infant suffered significant developmental and global delays, asthma and respiratory distress and is on a host of medications. The infant uses oxygen and has had multiple hospitalizations, in addition to needing a G-tube for feedings. Gastroenterology and nutritionists were recommended, though the family has been lax in this department. The infant requires occupational, physical and speech therapy, as well as special education.

Expert Opinions This case was reviewed by specialists in obstetrics and gynecology, radiology, emergency medicine and pediatrics. Their consensus was that an OB- GYN should follow up on the results of all ordered sonograms, discuss the results with the patient and provide counsel accordingly. This was clearly necessary in this case due to the serious nature of the fetal abnormality.

The radiology and ED experts agreed that, while it is the referring physician’s responsibility to advise the patient of all sonogram findings, they suggested that the radiologists should have communicated with the OB-GYN to ensure that the reports had been received, especially due to the findings.

The pediatric reviewer opined that the infant suffered from congenital defects and no treatment would have prevented the outcome. However, the mother was not counseled appropriately regarding the nature of the abnormalities and was denied the opportunity to terminate the pregnancy should this have been her choice.

Lawsuit The mother brought an action against multiple MLMIC-insured physicians to recover expenses related to childcare and alleging failure to provide appropriate ultrasound results that confirmed possible birth defects. She alleged that had she been provided with this information, she would have sought a termination of the pregnancy to avoid the expense of caring for a child with multiple deficits. The mother sought to recover expenses incurred to care for the infant’s special needs until the age of 21 and claimed that the child was disfigured (abdomen) and suffered from health issues, including omphalocele, a congenital hernia, hypertension and chronic respiratory issues.

During the patient’s deposition, she was questioned as to whether she would have undergone an abortion had she been aware of the infant’s condition when termination of the pregnancy was a viable option. She testified that “she did not know if she would have sought an abortion.” The patient was the recipient of social services and testified that, other than formula, she did not incur out-of-pocket expenses to care for the child, and, at most, her total expenditures were $1,000. The infant received Social Security Disability.

Although the plaintiff initially denied being pregnant during her deposition, it was clear that she was pregnant and was not forthcoming during her testimony. This tarnished her credibility.

The defense counsel felt that the damages in this case were not significant due to the testimony regarding the plaintiff’s minimal expenses and reasoned the chances of recovering on this matter would be questionable. As such, they were able to successfully obtain stipulations of discontinuance for all of the radiology defendants. A motion for summary judgment was made on behalf of the remaining physicians, which was granted. The plaintiff’s counsel did not seek an appeal, and our files were closed with no indemnity payments made on behalf of our policyholders.

A Legal and Risk Management Analysis In this situation, the favorable result for the defendants was not a victory to be celebrated. Although there was a fortunate legal outcome, there were clear deviations in the treatment that resulted in irreparable harm to the plaintiff. The failure to provide this patient with the test results revealing the fetal abnormality in a timely manner led to serious consequences.

First, the OB-GYN failed to follow up on the test results of the sonograms ordered. This resulted in a failure to discuss and appropriately counsel the patient about the crucial findings of the abnormality and allow the patient to make an informed decision about the progression of her pregnancy. It is the responsibility of the ordering physician to promptly follow up and review the results of diagnostic tests. This is critical for patient safety, and the failure to do so can lead to a delayed or missed diagnosis, as it did in the case at hand.

Medical offices need to have an effective test result tracking system that will efficiently follow up on test results to guarantee that they are received. They should also have communication policies and procedures that will ensure patients obtain these results in a timely manner. This communication is vital. Patients should know the results of any medical tests they have undertaken, especially those that have a significant finding.

Second, other than solely relying on the written report, the radiologists should have reported the abnormal test results to the ordering physician. As seen in this matter, the breakdown of communication and the failure to report the vital abnormal results directly to the ordering physician resulted in a delay to inform and a serious detrimental outcome for the patient.

Providing timely and accurate information on test results is essential for safe and effective healthcare.

MLMIC recognizes that communicating test results is an important part of providing care and may involve various healthcare professionals. Test results may be overlooked, lost, scanned into the wrong record or otherwise misplaced.

Abnormal test results requiring follow-up present an additional risk if they are not received, reviewed or communicated to the patient. This may result in missed or delayed diagnoses, patient injuries and subsequent claims of malpractice.

If a physician orders a test, he or she is responsible for ensuring that the results have been received and reviewed. Physician practices should have policies and procedures in place for the management of test results.

To review additional recommendations for communicating test results, look here .

This document is for general purposes only and should not be construed as medical or legal advice. This document is not comprehensive and does not cover all possible factual circumstances. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors for any questions related to legal, medical or professional obligations, the applicable state or federal laws or other professional questions.

• Share full article

Advertisement

Supported by

Study Suggests Genetics as a Cause, Not Just a Risk, for Some Alzheimer’s

People with two copies of the gene variant APOE4 are almost certain to get Alzheimer’s, say researchers, who proposed a framework under which such patients could be diagnosed years before symptoms.

By Pam Belluck

Scientists are proposing a new way of understanding the genetics of Alzheimer’s that would mean that up to a fifth of patients would be considered to have a genetically caused form of the disease.

Currently, the vast majority of Alzheimer’s cases do not have a clearly identified cause. The new designation, proposed in a study published Monday, could broaden the scope of efforts to develop treatments, including gene therapy, and affect the design of clinical trials.

It could also mean that hundreds of thousands of people in the United States alone could, if they chose, receive a diagnosis of Alzheimer’s before developing any symptoms of cognitive decline, although there currently are no treatments for people at that stage.

The new classification would make this type of Alzheimer’s one of the most common genetic disorders in the world, medical experts said.

“This reconceptualization that we’re proposing affects not a small minority of people,” said Dr. Juan Fortea, an author of the study and the director of the Sant Pau Memory Unit in Barcelona, Spain. “Sometimes we say that we don’t know the cause of Alzheimer’s disease,” but, he said, this would mean that about 15 to 20 percent of cases “can be tracked back to a cause, and the cause is in the genes.”

The idea involves a gene variant called APOE4. Scientists have long known that inheriting one copy of the variant increases the risk of developing Alzheimer’s, and that people with two copies, inherited from each parent, have vastly increased risk.

The new study , published in the journal Nature Medicine, analyzed data from over 500 people with two copies of APOE4, a significantly larger pool than in previous studies. The researchers found that almost all of those patients developed the biological pathology of Alzheimer’s, and the authors say that two copies of APOE4 should now be considered a cause of Alzheimer’s — not simply a risk factor.

The patients also developed Alzheimer’s pathology relatively young, the study found. By age 55, over 95 percent had biological markers associated with the disease. By 65, almost all had abnormal levels of a protein called amyloid that forms plaques in the brain, a hallmark of Alzheimer’s. And many started developing symptoms of cognitive decline at age 65, younger than most people without the APOE4 variant.

“The critical thing is that these individuals are often symptomatic 10 years earlier than other forms of Alzheimer’s disease,” said Dr. Reisa Sperling, a neurologist at Mass General Brigham in Boston and an author of the study.

She added, “By the time they are picked up and clinically diagnosed, because they’re often younger, they have more pathology.”

People with two copies, known as APOE4 homozygotes, make up 2 to 3 percent of the general population, but are an estimated 15 to 20 percent of people with Alzheimer’s dementia, experts said. People with one copy make up about 15 to 25 percent of the general population, and about 50 percent of Alzheimer’s dementia patients.

The most common variant is called APOE3, which seems to have a neutral effect on Alzheimer’s risk. About 75 percent of the general population has one copy of APOE3, and more than half of the general population has two copies.

Alzheimer’s experts not involved in the study said classifying the two-copy condition as genetically determined Alzheimer’s could have significant implications, including encouraging drug development beyond the field’s recent major focus on treatments that target and reduce amyloid.

Dr. Samuel Gandy, an Alzheimer’s researcher at Mount Sinai in New York, who was not involved in the study, said that patients with two copies of APOE4 faced much higher safety risks from anti-amyloid drugs.

When the Food and Drug Administration approved the anti-amyloid drug Leqembi last year, it required a black-box warning on the label saying that the medication can cause “serious and life-threatening events” such as swelling and bleeding in the brain, especially for people with two copies of APOE4. Some treatment centers decided not to offer Leqembi, an intravenous infusion, to such patients.

Dr. Gandy and other experts said that classifying these patients as having a distinct genetic form of Alzheimer’s would galvanize interest in developing drugs that are safe and effective for them and add urgency to current efforts to prevent cognitive decline in people who do not yet have symptoms.

“Rather than say we have nothing for you, let’s look for a trial,” Dr. Gandy said, adding that such patients should be included in trials at younger ages, given how early their pathology starts.

Besides trying to develop drugs, some researchers are exploring gene editing to transform APOE4 into a variant called APOE2, which appears to protect against Alzheimer’s. Another gene-therapy approach being studied involves injecting APOE2 into patients’ brains.

The new study had some limitations, including a lack of diversity that might make the findings less generalizable. Most patients in the study had European ancestry. While two copies of APOE4 also greatly increase Alzheimer’s risk in other ethnicities, the risk levels differ, said Dr. Michael Greicius, a neurologist at Stanford University School of Medicine who was not involved in the research.

“One important argument against their interpretation is that the risk of Alzheimer’s disease in APOE4 homozygotes varies substantially across different genetic ancestries,” said Dr. Greicius, who cowrote a study that found that white people with two copies of APOE4 had 13 times the risk of white people with two copies of APOE3, while Black people with two copies of APOE4 had 6.5 times the risk of Black people with two copies of APOE3.

“This has critical implications when counseling patients about their ancestry-informed genetic risk for Alzheimer’s disease,” he said, “and it also speaks to some yet-to-be-discovered genetics and biology that presumably drive this massive difference in risk.”

Under the current genetic understanding of Alzheimer’s, less than 2 percent of cases are considered genetically caused. Some of those patients inherited a mutation in one of three genes and can develop symptoms as early as their 30s or 40s. Others are people with Down syndrome, who have three copies of a chromosome containing a protein that often leads to what is called Down syndrome-associated Alzheimer’s disease .

Dr. Sperling said the genetic alterations in those cases are believed to fuel buildup of amyloid, while APOE4 is believed to interfere with clearing amyloid buildup.

Under the researchers’ proposal, having one copy of APOE4 would continue to be considered a risk factor, not enough to cause Alzheimer’s, Dr. Fortea said. It is unusual for diseases to follow that genetic pattern, called “semidominance,” with two copies of a variant causing the disease, but one copy only increasing risk, experts said.

The new recommendation will prompt questions about whether people should get tested to determine if they have the APOE4 variant.

Dr. Greicius said that until there were treatments for people with two copies of APOE4 or trials of therapies to prevent them from developing dementia, “My recommendation is if you don’t have symptoms, you should definitely not figure out your APOE status.”

He added, “It will only cause grief at this point.”

Finding ways to help these patients cannot come soon enough, Dr. Sperling said, adding, “These individuals are desperate, they’ve seen it in both of their parents often and really need therapies.”

Pam Belluck is a health and science reporter, covering a range of subjects, including reproductive health, long Covid, brain science, neurological disorders, mental health and genetics. More about Pam Belluck

The Fight Against Alzheimer’s Disease

Alzheimer’s is the most common form of dementia, but much remains unknown about this daunting disease..

How is Alzheimer’s diagnosed? What causes Alzheimer’s? We answered some common questions .

A study suggests that genetics can be a cause of Alzheimer’s , not just a risk, raising the prospect of diagnosis years before symptoms appear.

Determining whether someone has Alzheimer’s usually requires an extended diagnostic process . But new criteria could lead to a diagnosis on the basis of a simple blood test .

The F.D.A. has given full approval to the Alzheimer’s drug Leqembi. Here is what to know about i t.

Alzheimer’s can make communicating difficult. We asked experts for tips on how to talk to someone with the disease .

How to pass the Operational Case Study

As you may already know, Operational Case Study (OCS) is the first case study under CIMA's CGMA professional qualification and is designed to test your ability to apply the technical knowledge you’ve learnt from E1, P1 and F1.