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Sarah Meaney, Lamyia Anweigi, Hassan Ziada, Finbarr Allen
DOI: http://dx.doi.org/10.1093/ejo/cjt011 550 First published online: 5 April 2013

Dear Sir,

Thank you for the opportunity to reply to the letter to the editor where concerns were expressed regarding the methodological validity and rigour of the results of our qualitative study entitled “The impact of hypodontia: a qualitative study on the experiences of patients”. The issues raised are of great importance and we firmly believe that, as the author highlights, there is a real need for qualitative analysis to be comprehensive, rigorous, and, of course, reliable.

First, we would like to address the issues raised in relation to reflexivity and evaluative rigour. In qualitative research, it is acknowledged that achieving complete objectivity or a neutral standout is impossible and therefore the input and impact of researchers’ positions need to be considered in the study design and also throughout the course and completion of the study (Malterud, 2001). Three of the authors (LA, FA, and HZ) are clinicians who chose the area of investigation and the appropriateness of the implementation of a qualitative approach. Two of the authors (LA and FA) had clinical contact with the participants intended to be sampled. To maintain objectivity, SM, a sociologist with experience in undertaking qualitative studies, was brought into the study as an investigator who had no clinical or professional contact with the participants intended to be sampled.

Second, we would like to address the issues raised in relation to the reliability and interpretative rigour of our findings. It has been argued that pilot studies are not necessary in qualitative studies (Holloway, 1997) due to the process whereby upon completion of each interview, the interview schedule is critically reviewed by the interviewer. This process has been employed throughout this study and involves the constant evaluation of wording or phrasing of questions in the interview schedule. However, it is important to note that in this study, two pilot interviews were conducted to ensure that the interview schedule devised by the group was appropriate. These were reviewed and included in the main study as there were no major adjustments made to the interview schedule.

All interviews were undertaken by the primary author (SM); after each interview, a participant was given a summary of the findings, based on the notes taken during the interview, and asked if there was anything they would like to be removed or clarified or whether a topic that was not considered by the researcher should be added. This process was undertaken rather than participant validation as it has been argued that participants are primarily interested with their individual concerns (Barbour, 2001) and these can result in discrepancies if the researcher disregards their own interpretation (Mays and Pope, 2000).

In response to the query in relation to data analysis, a constant comparative method was utilized, whereby data collection and analysis proceeded concurrently until saturation was met; these were undertaken by SM. The interviews were analysed by SM using the aforementioned contemporaneous notes and interview transcripts. The second author (LA) then analysed the data independently before reviewing the findings of SM. There was agreement between the two authors (SM and LA) in relation to the main themes and these were then presented to FA and HZ for review.

We completely agree that qualitative methods are invaluable in addressing research questions that are difficult to answer using quantitative methodology and hope that our study encourages further interest in the use of qualitative research in dentistry.