[Qualitative research methods in clinical practice]

Evidence-based medicine (EBM) corresponds to the physician's ambition to integrate his/her experience with the best current scientific knowledge, applying this integrated proficiency to clinical problems. The concept of EBM has become widely accepted and given rise to a global network usually emphasizing the randomized clinical trial (RCT) as the most important scientific method. However, clinical situations are very complex. To a greater or less extent they are all composed of diverse factors, ranging from bio-medical ones to inter-subjective relations, values and beliefs. In addition to RCT and other quantitative procedures, qualitative scientific methods could be used to explore complex clinical problems. Clinical problems always deserve to be addressed from various perspectives. Unfortunately, RCT has acquired such a dominant position as to give the impression that it is the sole preferred method within the EBM framework. Based on three examples, the present article claims that it is the questions asked by an investigation that should determine one's choice of methods, not the reverse. Consequently, we argue that it is important to remember that RCT is just one out of several potential scientific methods. The respective utility of any one method depends on the clinical issue at hand.