Publishing qualitative research in medical journals.

Qualitative research makes an important contribution to research in the medical sciences. It has a particular role in providing understanding with respect to decisions and behaviours of patients and professionals, in exploring factors affecting the implementation of new interventions, and in developing theory in fields such as illness behaviour, clinical decision making, illness prevention, and health promotion. Qualitative research articles account for almost a quarter of submissions to the BJGP, with a similar acceptance rate for publication. About a quarter of the 40 most highly cited articles published in the BJGP in recent years employ qualitative methods. Although guidance on the conduct and reporting of qualitative studies has generally lagged behind those for quantitative research, guidance is now available. It includes recommendations such as COREQ,1 a set of reporting criteria making up a 32-item checklist for interviews and focus group-based research, and the more recently published Standards for Reporting Qualitative Research (SRQR), a 21-item checklist.2 Both of these instruments aim to improve the transparency of all aspects of qualitative research and are designed not only to help authors, but also to support editors and reviewers in evaluating manuscripts for publication and readers in critically appraising qualitative studies. However these recommendations do not tackle the problems of limited word counts and traditional reporting formats required by peer-reviewed journals in medicine; indeed, in many ways they exacerbate the problem by demanding more information. However, there is another more fundamental problem in publishing research that employs qualitative methods. This was brought into sharp relief in a recent exchange of correspondence in the BMJ that highlighted a clear policy to exclude qualitative research due to the view that results are largely exploratory and better suited to more ‘specialist’ journals, potentially limiting the reach of research using qualitative methodology.3,4 Aside from the particular policy taken by the BMJ, we argue that research which employs qualitative methods may be negatively viewed if it does not adhere to certain reporting standards. These are discussed below. In particular, we consider the importance of appropriately framing the research question and choosing the correct methodology, assessing the validity, reliability, and rigour of the report and its contribution to practice and theory. We also comment on particular issues including sampling, theoretical saturation, and reflexivity. Finally, the challenges of writing for publication in a medical journal and of peer review are discussed.