G'day!
Thanks for sending this around. Although for me, it is another very disappointing article. The talk given by Jennie Popay just recently at the Cochrane Colloquium did far more justice to the role of qualitative research in health care than did this article. My background is in patients' experiences and opinions (I was a consumer advocate for about 20 years). But this article is just plain disappointing. And it shows, as do many such pieces, a lack of understanding of EBHC. For a question such as, "is treatment x more effective than treatment y", then there is no escape from the hierarchy this is so distasteful to this author. BUT that is not the only question in health, and for other questions, other forms of evidence (including qualitative studies) can be best. We cannot have been so successful as this author fears, when this message is still not clear. And patients' priorities (knowing what works and what does harm) would not be served by pushing qualitative research into the wrong place because of the aspirations of the research community who undertakes it - we just need the right methods to be used to answer the questions that are out there. Different horses for different courses and all of that.
The idea that EBHC frees people from doubt is another disappointingly simplistic statement. Clearly, the more the knowledge grows, so too does our knowledge of the uncertainties at the margin. If anything, in fact, EBHC more often expands areas of uncertainty - and only exceptionally really removes doubt. To cope with EBHC, you have to have a high tolerance of uncertainty.
The specific question you raised, Marcus, about the statement on whether EBHC is going to send qualitative researchers to the periphery of the literature. It may look like EBHC dominates, but it doesn't. The medical literature is still more dominated by laboratory research, opinion pieces, case studies and the rest of it - not RCTs and systematic reviews.
More of a concern, I would think, is that psychometric research and QOL concepts could fully colonise the space where there should be room for qualitative research.
And beyond all of that, there remains this question: will there ever be more space in the literature for patients to speak directly, not mediated by researchers of any discipline or ideology?
Hilda
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Hilda Bastian
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-----Original Message-----
From: Evidence based health (EBH) [mailto:[log in to unmask]] On Behalf Of Marcus Tolentino Silva
Sent: Freitag, 3. November 2006 14:36
To: [log in to unmask]
Subject: Qualitative Health Research in the Era of Evidence-Based Practice
Hi all,
Grypdonck say in article of QUALITATIVE HEALTH RESEARCH (Vol. 16 No. 10, December 2006 1371-1385) that Evidence-based health care "leads to flirting with the quantitative researchers who decide about publication in high-ranking journals and so can undermine the true nature of qualitative research".
http://qhr.sagepub.com/cgi/reprint/16/10/1371.pdf
I don´t know if this is true. Does anyone have any opinion?
Thanks!
Marcus Tolentino
Farmacêutico/Consultor Técnico
DECIT/SCTIE/MS
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