Qualitative research can inform clinical practice

We were heartened to read the open letter,1 which echoes our own frustrations, but disappointed by the editors’ response.2

Their suggestion that qualitative research is only pertinent to a specialist audience is incorrect. As outlined in the open letter and corroborated by many responses, we believe that The BMJ’s readers are no less interested in the findings of high quality qualitative research than the specialists who call for more of this material. William Osler’s often quoted dictum “Listen to the patient. He is telling you the diagnosis”3 is a clear reference to the traditional primacy of qualitative histories in “help[ing] doctors to make better decisions”—the stated aim of The BMJ. All doctors depend on qualitative evidence—patients’ symptoms, concerns, and circumstances—to guide their practice. Although The BMJ provides a platform for patients’ views, as scientists we think a leading medical journal should be at least as concerned with scientific inquiry in this area. Qualitative research has established rigorous methods and can inform clinical practice, as The BMJ’s recent “top 20” articles show.1

The editors rightly point out that qualitative research may not provide generalisable answers. However, it does not claim to do so. The transferability of insights from qualitative research is rigorously debated—often more so than for quantitative studies with high internal validity and low external validity. Single randomised controlled trials often do not provide generalisable answers either.4