Qualitative research in health care: Assessing quality in qualitative research

Abstract

Two opposing views There has been considerable debate over whether qualitative and quantitative methods can and should be assessed according to the same quality criteria. Extreme relativists hold that all research perspectives are unique and each is equally valid in its own terms, but this position means that research cannot derive any unequivocal insights relevant to action, and it would therefore command little support among applied health researchers.6 Other than this total rejection of any quality criteria, it is possible to identify two broad, competing positions, for and against using the same criteria.7 Within each position there is a range of views. Separate and different: the antirealist position Advocates of the antirealist position argue that qualitative research represents a distinctive paradigm and as such it cannot and should not be judged by conventional measures of validity, generalisability, and reliability. At its core, this position rejects naive realism—a belief that there is a single, unequivocal social reality or truth which is entirely independent of the researcher and of the research process; instead there are multiple perspectives of the world that are created and constructed in the research process.8 Relativist criteria for quality7 Degree to which substantive and formal theory is produced and the degree of development of such theory Novelty of the claims made from the theory Consistency of the theoretical claims with the empirical data collected Credibility of the account to those studied and to readers Extent to which the findings are transferable to other settings Reflexivity of the account—that is, the degree to which the effects of the research strategies on the findings are assessed or the amount of information about the research process that is provided to readers Those relativists who maintain that assessment criteria are feasible but that distinctive ones are required to evaluate qualitative research have put forward a range of different assessment schemes. In part, this is because the choice and relative importance of different criteria of quality depend on the topic and the purpose of the research. Hammersley has attempted to pull together these quality criteria (box).7 These criteria are open to challenge (for example, it is arguable whether all research should be concerned to develop theory). At the same time, many of the criteria listed are not exclusive to qualitative research. Using criteria from quantitative research: subtle realism Other authors agree that all research involves subjective perception and that different methods produce different perspectives, but, unlike the anti-realists, they argue that there is an underlying reality which can be studied. 9 10 The philosophy of qualitative and quantitative researchers should be one of “subtle realism”—an attempt to represent that reality rather than to attain “the truth.” From this position it is possible to assess the different perspectives offered by different research processes against each other and against criteria of quality common to both qualitative and quantitative research, particularly those of validity and relevance. However, the means of assessment may be modified to take account of the distinctive goals of qualitative research. This is our position. Further reading Murphy E, Dingwall R, Greatbatch D, Parker S, Watson P . Qualitative research methods in health technology assessment: a review of the literature. Health Technology Assessment 1998;2(16). Dingwall R, Murphy E, Watson P, Greatbatch D, Parker S . Catching goldfish: quality in qualitative research. Journal of Health Services Research and Policy 1998;3:167–72.