Intended for healthcare professionals

Rapid response to:

Research Methods & Reporting

Critical reflections on the rise of qualitative research

BMJ 2009; 339 doi: (Published 15 September 2009) Cite this as: BMJ 2009;339:b3425

Rapid Response:

Re: Critical reflections on the rise of qualitative research

To the Editor,

I am writing this letter as a response to "Critical reflections on the rise of qualitative research" by Pope and Mays (2009). My letter touches upon the point discussed about the nature of qualitative inquiry. In the article, the authors discuss how induction is what qualitative research should focus more on, and including deductive aspects in qualitative studies is a bit ‘odd’ comparatively.

As the authors explain, induction is indeed one of the main aspects in qualitative research. Inductive, exploratory studies which look into new paradigms, bring paradigms to a new territory (Newman and Cooper, 1993), find new variables or conditions (Aguinis et al., 2013) etc. are found to have a higher contribution to as well as impact on scholarly community, when compared to studies that merely refine or extend an existing idea. From this perspective, inductive qualitative studies are considered most appropriate in the early phases of new theory building. However, even an inductive study cannot avoid incorporating elements of deduction in it (Strauss, 1987).

Most qualitative studies, even the exploratory ones, often involve induction and deduction simultaneously (Miles and Huberman, 1984). For instance, selecting participants in a qualitative study often requires theoretical sampling. By definition, this incorporates existing theory or deductive logic into the qualitative study. Likewise, the research design and framework (as the authors state here) of a qualitative study is also informed by existing theory. However, the benefits of having such a framework goes beyond just providing a systematic (and seductive) outline or scaffold. The deductive structure makes sure that the researchers are at least familiar with the involved dimensions (Perry and Jensen, 2001), before a study commences. Studies following this logic thus begin with a rule or awareness of the relevant dimensions. As these studies proceed, the findings either confirm or refute this pre-conceived understanding of the involved dimensions. The inductive element then comes into play when one looks for the reasons behind these findings.

An example for the same is the analysis of negative or deviant cases (Gibbert et al., 2014). Spotting a negative case constitutes the starting point for iterative cycles of theory generation in several studies: that is, a case that does not fit the emerging theory prompts another cycle of data collection and theoretical refinement via constant comparison. This iteration often points to a new causal condition, or a causal mechanism which led to the said deviancy of the case. Here, theory is built through deduction coupled with induction. Evidently, if there was no deductive framework which helps one identify the negative or dissimilar case, iterations would have remained limited to one cycle only, defying the main procedural characteristics of theory building. Fields like biology (Hagstrum 2013), comparative politics (Emigh 1997, Gerring 2007), criminology (Sullivan 2011) etc. have identified this theory building potential of studies involving both induction and deduction. Applying this logic in medical sciences will thus contribute to impactful theory development.


Aguinis, H., Gottfredson, R. K., & Joo, H. (2013). Best-practice recommendations for defining, identifying, and handling outliers. Organizational Research Methods, 16(2), 270-301.

Emigh, R.J. (1997). The power of negative thinking: The use of negative case methodology in the development of sociological theory. Theory and Society, 26(5), 649-684.

Gerring, J. (2007). Case Study Research : Principles and Practices. Cambridge : Cambridge University Press.

Gibbert, M., Nair, L.B., & Weiss, M. (2014). “Oops, I’ve got an outlier in my data—what now?” Using the Deviant Case Method for theory building. Paper presented at the 74th Academy of Management Annual Meeting, Philadelphia, USA.

Hagstrum, J.T. (2013). Atmospheric propagation modeling indicates homing pigeons use loft–specific infrasonic ‘map’ cues. The Journal of Experimental Biology, 216(4), 687–699.

Miles, M. B. & Huberman, A. M. (1984). Qualitative Data Analysis: A Sourcebook of New Methods. London: Sage publications.

Perry, C., & Jensen, O. (2001, December). Approaches to combining induction and deduction in one research study. In Australian and New Zealand Marketing Academy Conference Massey University, Auckland, New Zealand.

Pope, C., & Mays, N. (2009). Critical reflections on the rise of qualitative research. BMJ, 339, b3425.

Strauss, A. L. (1987). Qualitative analysis for social scientists. Cambridge University Press.

Sullivan, C.J. (2011). The utility of the deviant case in the development of criminological theory. Criminology, 49(3), 905-920.

Competing interests: No competing interests

26 July 2017
Lakshmi Balachandran Nair
Assistant Professor
Utrecht University
Sjoerd Groenmangebouw, Padualaan 14, Utrecht, The Netherlands, 3584 CH