What is quality in qualitative health research?
- 1RCN Research Institute, School of Health and Social Studies, University of Warwick, Warwick, UK
- 2Physiotherapy Research Unit, Nuffield Orthopedic Centre, Oxford, UK
- Correspondence to Kate Seers
RCN Research Institute, School of Health & Social Studies, University of Warwick, Coventry, Warwick, CV4 7AL, UK;
Assessing whether the research we are reading is any good is often a challenge. If we are going to use a study's findings to change how we think and how we practice, we want to have confidence in the findings.
What do you need to look for in qualitative research to show that the study is of high quality? The answer is not straightforward, even though there are many different criteria available for judging qualitative research – Dixon-Woods et al1 reports there are over 100 proposals for identifying quality in qualitative research. Spencer et al2 drew on 29 existing frameworks to produce a framework to assess quality, which consists of an extensive 18 different domains.
Some researchers argue against criteria for judging qualitative research. Bochner3 points out that it is not that one side believes you should judge research quality and another side does not. The key issue as he sees it is that one side believes you can construct criteria and apply them to make choices, and the other side argues that these choices are ‘inextricably tied to our values and our subjectivities’. He describes these differences as unresolvable.
Dixon-Woods et al1 take a pragmatic approach. While they acknowledge these tensions, they recognise that in order to use research its robustness needs to be assessed. They argue that there are common features of all qualitative research. Their prompts for appraising qualitative research include the following: Are the research questions clear? Are the research questions suited to qualitative inquiry? Are sampling, data collection and analysis clearly described and appropriate to the research question? Are claims made supported by sufficient evidence? Are the data, interpretations and conclusions clearly integrated? Does the paper make a useful contribution? They describe these prompts as cues to think about the issues rather than explicit criteria, and suggest that quality assessment will inevitably involve subjective judgement by the reader. They suggest that prompts specific to different methods of data collection and theoretical perspectives could be added, which could help the readers to differentiate between minor errors and fatal flaws. Other authors, such as Tracy4, Caelli et al5 and CASP6 have also produced generic criteria for assessing the quality of qualitative research.
Even with criteria or prompts, judging quality can be complex. For example, as Dixon-Woods et al1 highlight, it is possible to have a study that clearly describes what they have done, but has weak interpretation, and another that has poorly reported procedures, but offers well grounded insights. This supports Guba and Lincoln7 who emphasise the importance of being interpretatively rigorous or put another way, you need to judge the quality of the author's interpretation. For example, has the author compared their own interpretation to those of others, or shown that they have looked at their findings from different angles, such as including negative cases?
So although there are challenges to assessing qualitative research, it is important to know whether the qualitative research you want to use is robust. The prompts of Dixon-Wood et al1 or CASP6 criteria are a useful starting place.
Competing interests None.