Intended for healthcare professionals

Rapid response to:


An open letter to The BMJ editors on qualitative research

BMJ 2016; 352 doi: (Published 10 February 2016) Cite this as: BMJ 2016;352:i563

Rapid Response:

Re: An open letter to The BMJ editors on qualitative research

I support Greenhalgh et al's open letter to the BMJ (1) and their calls for a review of policy on the value of qualitative research. I am a Wellcome funded early career researcher, exploring prognosis in COPD. Having navigated a rigorous process of peer review and successfully persuaded an international panel that a mixed methods study is of value in this field, I am sure that the Wellcome Trust and other funding bodies would be alarmed that the BMJ feel such research would be 'an extremely low priority' for publication within its pages.

I am in the early stages of my fellowship, and am simultaneously up-skilling in quantitative and qualitative methods. As I split myself between these two worlds, methodological rigour and a critical lens have proved to be the glue keeping me together. In fact, by forcing me to focus on questions of epistemology and ontology, qualitative research methods have made me look at the benefits and limitations of quantitative methods afresh. There are fundamental beliefs and structures which frame what research is prioritised, which are not challenged often enough, and there are norms within the research world that are not always in line with the aim of advancing human knowledge. The use and abuse of the p value (2) is just one example of how an over-reliance on 'numbers as truth' can provide an illusion of certainty which is damaging to research and healthcare.

In addition to studying for a PhD I am a trainee in Respiratory medicine. A striking aspect of my higher clinical training has been a growing acceptance of the fact that we think and practise in a world where knowledge is contested. Although the evidence hierarchy situates the meta-analysis of randomised control trials at the top of the pyramid, we practice in a reality where there are no trials to answer many questions, or the results are not applicable to the patient in front of us, often due to age, ethnicity or co-morbidity. My clinical role models recognise the complexity of their patients and see beyond the biological to the psychosocial, spiritual, individual and subjective. This not only makes them more compassionate and human, but also makes them more effective as partners in healthcare. I would therefore suggest that high quality qualitative research is as relevant, if not more so, to the everyday practice of the BMJ's audience of 'general clinical readers' and has great practical value.

I support the call from Greenhalgh et al for a monthly slot for a qualitative paper, with an accompanying methodological commentary from an international expert. This has the potential to further enhance the research literacy of the clinical community and would be of great value to early career researchers looking to expand their toolkit in answering the most pressing questions of our age.

1. Greenhalgh T, Annandale E, Ashcroft R, et al. An open letter to The BMJ editors on qualitative research. BMJ 2016;352:i563.
2. Nuzzo R. Statistical errors: P values, the ‘gold standard’ of statistical validity, are not as reliable as many scientists assume. Nature. 2014;506(150):52.

Competing interests: No competing interests

17 February 2016
Laura-Jane E Smith
Clinical Research Fellow
Department of Respiratory Epidemiology, Occupational Medicine and Public Health, NHLI, Imperial College London
G08, Emmanuel Kaye Building, Manresa Road, National Heart and Lung Institute, Imperial College, London, SW3 6LR