Practice Qualitative Research

An introduction to reading and appraising qualitative research

BMJ 2008; 337 doi: http://dx.doi.org/10.1136/bmj.a288 (Published 07 August 2008) Cite this as: BMJ 2008;337:a288
  1. Ayelet Kuper, assistant professor1,
  2. Scott Reeves, associate professor2,
  3. Wendy Levinson, Sir John and Lady Eaton professor and chair1
  1. 1Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5
  2. 2Department of Psychiatry, Li Ka Shing Knowledge Institute, Centre for Faculty Development, and Wilson Centre for Research in Education, University of Toronto, 200 Elizabeth Street, Eaton South 1-565, Toronto, ON, Canada M5G 2C4
  1. Correspondence to: A Kuper ayelet94{at}post.harvard.edu

    This article explores the difference between qualitative and quantitative research and the need for doctors to be able to interpret and appraise qualitative research

    The number of qualitative research articles published in medical journals has increased substantially over the past few years.1 Qualitative studies have contributed to our understanding of important clinical issues, such as patients’ reasons for following or abandoning medical recommendations2 3 and patients’ and carers’ needs and wishes at the end of life.4 5 None the less, healthcare professionals still have strong concerns about a widespread lack of understanding of the nature and uses of such research.1 6 7

    This knowledge gap can be particularly problematic for a physician who is asked to review, for a journal or a grant agency, one of the increasing numbers of papers that makes use of qualitative or “mixed” (combined quantitative and qualitative) methods. Several articles in various medical subfields8 9 10 have highlighted this problem in the review process. It can lead to refusals by journals to publish well conducted research because of a lack of understanding of the methods involved.10 However, this same knowledge deficit among reviewers can also result in the acceptance and publication of qualitative articles that are methodologically poor.9

    Arguments from the proponents of evidence based medicine about the need for clinicians to evaluate evidence and incorporate it into their own practice are now well accepted. Busy clinicians often depend on journals’ peer review processes to evaluate the evidence for them, but this strategy is less reliable for qualitative papers than it is for their quantitative counterparts. However, although physicians who routinely read medical journals are increasingly able to critically appraise methodologically straightforward quantitative studies (and have access to excellent published resources11 12 for evaluating more complex studies), …

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