Accepted Paper:

Integrating interviews into quantitative domains: reaching the parts controlled trial can't reach   

Author:

Alexandra Greene (University of Aberdeen)

Paper short abstract:

The interview, with its focus on subjective perceptions, experiences and the contextual detail of social interaction has, in the past, been seen as oppositional to other quantitative, evidence-based methods used in randomised controlled trials (RCT). Similarly, in health services research (HSR), notions of hierarchies exist between the ‘gold standard of evidence’ – the RCT - and observational studies (Rawlins, Lancet, 2008). As anthropologists have increasingly become more applied and RCTs have increasingly been developed to tackle ‘real world’ questions through complex and pragmatic designs, the contribution of anthropology has begun to be viewed as an important part of a more integrated approach to trials.

Paper long abstract:

Attaching labels of 'evidence' to particular types of 'knowing' is a political act, which is complex, shifting and ambiguous (Nutley et al (2007). This is understandable as groupings jostle for power and challenge the way others judge and construct their own truths (Engelke 2008). Trialists for example, maintain serious concerns that the inclusion of interviews in RCTs might sabotage their research, which can lead to schemes that ensure that the 'effects' of the interview are minimised.

This presentation describes an anthropologist working alongside clinical trialists in a study to develop a national screening programme. Her role was to interview providers of services about such a screening programme. When she began her research she noticed that the trialists were determined to contain the interviews by writing the interview script for her, as a questionnaire, and restricting who she was able to speak to. The anthropologist's emersion in the trialists' arena uncovered these fears and with them a better understanding of how to circumvent these constraints and mediate the scripted questions with a more flexible approach to give the providers a chance to speak up and have their say.

Panel P11
Current concerns in contemporary critical medical ethnography: resisting a structural anaemia in respect to a new politics of evidence