Qualitative research in health care: assessing quality in qualitative research

British Medical Journal, Jan 1, 2000 by Nicholas Mays, Catherine Pope

Is there any place for quality guidelines?

Whether quality criteria should be applied to qualitative research, which criteria are appropriate, and how they should be assessed is hotly debated. It would be unwise to consider any single set of guidelines as definitive. We list some questions to ask of any piece of qualitative research (box); the questions emphasise criteria of relevance and validity. They could also be used by researchers at different times during the life of a particular research project to improve its quality.

Conclusion

Although the issue of quality in qualitative health and health services research has received considerable attention, a recent paper was able to argue, legitimately, that "quality in qualitative research is a mystery to many health services researchers."[12] However, qualitative researchers can address the issue of quality in their research. As in quantitative research, the basic strategy to ensure rigour, and thus quality, in qualitative research is systematic, self conscious research design, data collection, interpretation, and communication. Qualitative research has much to offer. Its methods can, and do, enrich our knowledge of health and health care. It is not, however, an easy option or the route to a quick answer. As Dingwall et al conclude, "qualitative research requires real skill, a combination of thought and practice and not a little patience."[12]

We acknowledge the contribution of the HTA report on qualitative research methods by Elizabeth Murphy, Robert Dingwall, David Greatbatch, Susan Parker, and Pamela Watson to this paper. We thank these authors for their careful exposition of a tangled series of debates, and their timely publication of this literature review.

The views expressed in this paper are those of the authors and do not necessarily reflect the views of the New Zealand Treasury, in the case of NM. The Treasury takes no responsibility for any errors or omissions in, or for the correctness of the information contained in this article.

Competing interests: None declared.

Summary points

Qualitative methods are now widely used and increasingly accepted in health research, but quality in qualitative research is a mystery to many health services researchers

There is considerable debate over the nature of the knowledge produced by such methods and how such research should be judged

Antirealists argue that qualitative and quantitative research are very different and that it is not possible to judge qualitative research by using conventional criteria such as reliability, validity, and generalisability

Quality in qualitative research can be assessed with the same broad concepts of validity and relevance used for quantitative research, but these need to be operationalised differently to take into account the distinctive goals of qualitative research

Relativist criteria for quality[7]

* 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