G'evening
I couldn’t agree more with Hilda. Qualitative researchers don’t need to justify their
existence neither do they need seek permission from they quantitative colleagues
for a room in evidence based health care. The truth is that qualitative research
addresses research questions that are different from those considered by
quantitative studies. The issue is not about what method ranks highest in the
hierarchy of evidence it is about whit method is the best in addressing the
question we intend to address. Rational practitioners are concern not only with the
strength of evidence of effectiveness but they are also interested in how much of
evidence actually get into practice? What are the best ways of getting the
evidence into practice?
The value of qualitative research lies in its ability to pursue systematically these
kinds of research questions that are not easily answerable by experimental
methods. Quantitative methods can provide evidence about the effectiveness of the
disease treatment, but it doe not answer the questions about general practitioners’
perception and experiences in use of clinical guidelines and patients’ experiences
of using the prescribed medication.
Andi
Quoting "Bastian, Hilda" <[log in to unmask]>:
> 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
>
> = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = =
>
> Hilda Bastian
>
> Ressortleiterin Gesundheitsinformation
> Chefredakteurin: www.gesundheitsinformation.de
> www.informedhealthonline.org
>
> Head of Health Information Department
> Editor in Chief:
> www.informedhealthonline.org
> www.gesundheitsinformation.de
>
> Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen
>
> Institute for Quality and Efficiency in Health Care
>
> Dillenburger Str. 27
> D-51105 Köln, Germany
>
> tel: + 49-221 / 35685-401
> fax: + 49-221 / 35685-1
> email: [log in to unmask]
>
> http://www.iqwig.de
>
>
> -----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.voyager.chester.ac.uk/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
>
--
Mzwandile Andi Mabhala, FRIPH
Programme leader in Public Health
School of Health and Social Care
University of Chester
Parkgate Road
Chester
CH2 4BJ
Tel:07947158562 or 01244 511634
|