Are we on the cusp of a fourth research paradigm? Predicting the future for a new approach to methods-use in medical and health services research

Frances Rapport, Jeffrey Braithwaite
2018 BMC Medical Research Methodology  
The dominant medical and health research paradigm continues to be quantitative. While the authors sense a sea-change in opinion about mixed-method research, underpinned by two decades of highly-cited publications in medical journals, much of the medical literature still widely favours the Randomised Control Trial. Main body: This debate article examines whether it is the beginning of the end of the dominant quantitative paradigm and the interest this holds for researchers and clinicians at the
more » ... orefront of care delivery. It examines the Third Research Paradigm, signifying the importance of mixed-methods, and discusses the power of the patient voice and person-focused research activity. The authors discern the coming of age of a Fourth Research Paradigm integrating mixed-methods with data collected 'on the hoof'. Within this new paradigm, the article explores the power of available, real time, and emergent datafrom smart phones, wearable devices, and social media, as well as more creative approaches to data collection. The Fourth Research Paradigm will require the support of multi-disciplinary teams, moving through the world alongside their research subjects. The impact of a Fourth Research Paradigm on the health researcher is assessed, as the researcher's gaze moves away from considerations of methodological superiority to re-considerations of their role in the brave new world of research multiplicity. Conclusion: The Fourth Research Paradigm offers extensive opportunities to tell more complete research stories in real-time settings. It concentrates on contextual notions of everyday happenings within the ever-changing world of healthcare delivery. There will be challenges ahead, not least the management of large, complex datasets and adaptive study designs. But rigorous planning will enable unique insights into the relationships played out in the world of the patient and healthcare provider. Better care and new delivery models are likely to result, but how this will manifest is not yet clear. Keywords: Fourth research paradigm, Third research paradigm, Mobile methods, Qualitative research, Methodological development, Complexity, The future of healthcare The role of qualitative methods in the future of health services research Between 1993 and 2000, an influential series of papers on the role of qualitative methods in medical and health services research was warmly received (See for example [1] [2] [3] ). Following publication, the series sparked extensive and ongoing interest in new opportunities for mainstream medical research to incorporate qualitative methods as a matter of course. Years later, however, a group of 76 senior academics from 11 countries took issue with the British Medical Journal for rejecting qualitative research contributions too readily, and for instead privileging quantitative studies, particularly randomised controlled trials (RCTs) [4] . The 76 advocates showed that the citations for the most influential qualitative research papers were much higher
doi:10.1186/s12874-018-0597-4 fatcat:4q2nyncspjginhraedk6ygysf4