Cited by 1,084Educational Research and MethodsQualitative Research Methods and ApplicationsBusiness Strategies and Management Research

The DOI matches its Crossref record; 49 of the 53 references it cites were found in a registry or an index; none of the 19 sources its claims cite is checked for support yet.

Revisiting the Quantitative-Qualitative Debate: Implications for Mixed-Methods Research

Open access
Sale, Joanna E. M., Lohfeld, Lynne H., Brazil, Kevin·2002·Quality and Quantity

Abstract

Health care research includes many studies that combine quantitative and qualitative methods. In this paper, we revisit the quantitative-qualitative debate and review the arguments for and against using mixed-methods. In addition, we discuss the implications stemming from our view, that the paradigms upon which the methods are based have a different view of reality and therefore a different view of the phenomenon under study. Because the two paradigms do not study the same phenomena, quantitative and qualitative methods cannot be combined for cross-validation or triangulation purposes. However, they can be combined for complementary purposes. Future standards for mixed-methods research should clearly reflect this recommendation.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This conceptual paper revisits the quantitative–qualitative debate and argues that the two paradigms rest on incompatible ontological and epistemological assumptions, so they do not study the same phenomena. The authors conclude that mixed-methods research cannot legitimately combine the two for cross-validation or triangulation, but can combine them for complementary purposes if the distinct phenomenon examined by each method is explicitly labelled.

Key findings

  • Quantitative research is grounded in positivism (one objective reality independent of perception; investigator and investigated are independent), while qualitative research is grounded in interpretivism and constructivism (multiple socially constructed realities; investigator and investigated are interactively linked). Because of these differences, the paradigms are incommensurate — "the one [paradigm] precludes the other just as surely belief in a round world precludes belief in a flat one" (Guba, 1987: 31).
  • Although both paradigms may use identical labels for phenomena, the labels refer to different things: for the quantitative researcher a label refers to an external referent, for the qualitative researcher to a personal interpretation or meaning. The authors illustrate with factory records and surgical waiting lists.
  • Combining methods for cross-validation/triangulation is therefore not viable, and complementarity aimed at different aspects of the *same* phenomenon is also inadvisable. The authors cite Greene and Caracelli's (1989) review of mixed-method evaluation studies, in which methodological triangulation was used by only 3 of 57 studies.
  • Their proposed solution: combine methods for complementary purposes while explicitly labelling the distinct phenomenon each method examines — e.g., "a qualitative study of the lived experience of burnout to inform a quantitative measure of burnout."

Methods

  • Design: a conceptual/theoretical paper that revisits the quantitative–qualitative debate of the 1970s and 1980s and reviews arguments for and against mixed-methods, drawing on prior literature rather than collecting new data.
  • Analysis: argumentative/philosophical analysis organized around paradigm assumptions (ontology, epistemology, methodology), the arguments advanced for mixing methods, the nature of the phenomenon of study, and further considerations in mixed-method designs.
  • No empirical sample, dataset, or statistical analysis is reported.

Limitations

  • The paper states no formal limitations section. It acknowledges that its information "is not new" in the sense of making a new case for or against the debate, and that its contribution is a proposed "new" solution for using mixed-methods.
  • Evident from the text: the argument is conceptual and rests on the authors' own paradigmatic position (that the qualitative paradigm assumes no external referents for understanding reality), which they assert against opposing views such as Reichardt and Rallis (1994) and Howe (1988, 1992); no empirical test of the proposed solution is offered.
  • The paper notes that the extent of disagreement between qualitative and quantitative results is rarely known because it is often not reported, and that the growing trend of quantifying qualitative research may diminish the value of both methods.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1023/a:1014301607592

Cites

49 of 49 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

0 of 19 cited sources checked · 0 supported · 0 flagged

  • Interpretationreasoning
    § Abstract

    Quantitative and qualitative methods cannot be combined for cross-validation or triangulation purposes.

    “Because the two paradigms do not study the same phenomena, quantitative and qualitative methods cannot be combined for cross-validation or triangulation purposes.”
    • Also stated in: § 4. The Phenomenon of Study · plain
      “Having taken the position that the quantitative and qualitative paradigms do not study the same phenomena, it follows that combining the two methods for cross-validation/triangulation purposes is not a viable option.”
    Quote in the paperNot a substantial claim
  • Premisecitation
    § 2. The Two Paradigms

    The different assumptions of the quantitative and qualitative paradigms originated in the positivism-idealism debate of the late 19th century.

    “The different assumptions of the quantitative and qualitative paradigms originated in the positivism-idealism debate of the late 19th century (Smith, 1983).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Smith, 1983 source
  • Interpretationreasoning
    § Abstract

    Quantitative and qualitative methods can be combined for complementary purposes.

    “However, they can be combined for complementary purposes.”
    • Also stated in: § 6. Our Solution · plain
      “However, the fact that the approaches are incommensurate does not mean that multiple methods cannot be combined in a single study if it is done for complementary purposes.”
    Quote in the paperNot a substantial claim
  • Premisecitation
    § 5. Further Considerations in Mixed-Method Research Designs

    The most frequently used mixed-method designs start with a qualitative pilot study followed by quantitative research.

    “The most frequently used mixed-method designs start with a qualitative pilot study followed by quantitative research (Morgan, 1998).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Morgan, 1998 source
  • Interpretationreasoning
    § Abstract

    The quantitative and qualitative paradigms do not study the same phenomena.

    “Because the two paradigms do not study the same phenomena, quantitative and qualitative methods cannot be combined for cross-validation or triangulation purposes.”
    • Also stated in: § 1. Introduction · boosted
      “In fact, based on their paradigmatic assumptions, the two methods do not study the same phenomena.”
    Quote in the paperNot a substantial claim
  • It may state two separate claims as one. 15
  • Probably not a substantial claim. 24
  • It may state two separate claims as one.

    Premisecitation
    § 2. The Two Paradigms

    The qualitative paradigm is based on interpretivism and constructivism.

    “In contrast, the qualitative paradigm is based on interpretivism (Altheide and Johnson, 1994; Kuzel and Like, 1991; Secker et al., 1995) and constructivism (Guba and Lincoln, 1994).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Altheide and Johnson, 1994
    • cites Kuzel and Like, 1991
    • cites Secker et al., 1995 source
  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given
    § 6. Our Solution

    The key issues in the quantitative-qualitative debate are ontological and epistemological.

    “The key issues in the quantitative-qualitative debate are ontological and epistemological.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Interpretationnone given
    § 3. Arguments Presented for Mixed-Method Research

    Conducting a frequency count on responses to open-ended questions is not qualitative research.

    “Conducting a frequency count on responses to open-ended questions is not qualitative research.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim.

    Premisecitation
    § 5. Further Considerations in Mixed-Method Research Designs

    For research to be valid or reliable in the narrow quantitative sense requires that what is studied be independent of the inquirer and be described without distortion by her interests, values, or purposes.

    “For research to be valid or reliable in the narrow (quantitative) sense requires that what is studied be independent of the inquirer and be described without distortion by her interests, values, or purposes (Smith and Heshusius, 1986).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Smith and Heshusius, 1986 source
  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation
    § 2. The Two Paradigms

    In the qualitative paradigm, there is no access to reality independent of our minds, no external referent by which to compare claims of truth.

    “On an epistemological level, there is no access to reality independent of our minds, no external referent by which to compare claims of truth (Smith, 1983).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Smith, 1983 source
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisereasoning
    § 2. The Two Paradigms

    The ontological position of the quantitative paradigm is that there is only one truth, an objective reality that exists independent of human perception.

    “The ontological position of the quantitative paradigm is that there is only one truth, an objective reality that exists independent of human perception.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. It may be too vague to check against evidence. It may state two separate claims as one.

    Premisenone given
    § 4. The Phenomenon of Study

    For the quantitative researcher, a label refers to an external referent; for a qualitative researcher, a label refers to a personal interpretation or meaning attached to phenomena.

    “For the quantitative researcher, a label refers to an external referent; to a qualitative researcher, a label refers to a personal interpretation or meaning attached to phenomena.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. It may state two separate claims as one.

    Premisereasoning
    § 5. Further Considerations in Mixed-Method Research Designs

    Qualitative studies are based on the minimum distance between the investigator and the investigated, and seek multiple definitions of reality embedded in various respondents' experiences.

    “They are based on the minimum distance between the investigator and the investigated, and seek multiple definitions of reality embedded in various respondents’ experiences.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds.

    Interpretationnone given
    § 6. Our Solution

    Each method studies different phenomena.

    “Each method studies different phenomena.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. The paper’s conclusions may not depend on it.

    Premisecitation
    § 2. The Two Paradigms

    In the qualitative paradigm, the investigator and the object of study are interactively linked so that findings are mutually created within the context of the situation.

    “The investigator and the object of study are interactively linked so that findings are mutually created within the context of the situation which shapes the inquiry (Guba and Lincoln, 1994; Denzin and Lincoln, 1994).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Guba and Lincoln, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites Denzin and Lincoln, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.

    Premisecitation
    § 2. The Two Paradigms

    Ontologically, the qualitative paradigm holds that there are multiple realities or multiple truths based on one's construction of reality, and reality is socially constructed and constantly changing.

    “Ontologically speaking, there are multiple realities or multiple truths based on one’s construction of reality. Reality is socially constructed (Berger and Luckmann, 1966) and so is constantly changing.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Berger and Luckmann, 1966

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Interpretationnone given
    § 3. Arguments Presented for Mixed-Method Research

    We rarely know the extent of disagreement between qualitative and quantitative results because that is often not reported.

    “The truth is we rarely know the extent of disagreement between qualitative and quantitative results because that is often not reported.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. It may be too vague to check against evidence.

    Interpretationreasoning
    § 6. Our Solution

    This solution implies an additive outcome for mutual research partners.

    “This implies an additive outcome for mutual research partners.”
    Quote in the paperNot a substantial claim
  • It may state two separate claims as one.

    Interpretationreasoning
    § 6. Our Solution

    Quantitative and qualitative methods represent two different paradigms and are incommensurate.

    “Because quantitative and qualitative methods represent two different paradigms, they are incommensurate.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: One cannot be both a positivist and an interpretivist or constructivist.
  • Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationreasoning
    § 6. Our Solution

    The distinction of phenomena in mixed-methods research is crucial and can be clarified by labelling the phenomenon examined by each method.

    “The distinction of phenomena in mixed-methods research is crucial and can be clarified by labelling the phenomenon examined by each method.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.

    Premisenone given
    § 3. Arguments Presented for Mixed-Method Research

    The positivist worldview predominates in health care research.

    “Given the overwhelming predominance of the positivist worldview in health care research, this is not surprising.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The positivist paradigm has become the predominant frame of reference in the physical and social sciences.
  • Probably not a substantial claim. The paper may give no reason why it holds.

    Premisenone given
    § 2. The Two Paradigms

    The quantitative paradigm is based on positivism.

    “The quantitative paradigm is based on positivism.”
    Quote in the paperNot a substantial claim
  • It may state two separate claims as one.

    Interpretationreasoning
    § 4. The Phenomenon of Study

    Both quantitative and qualitative paradigms may use common labels to refer to phenomena, but what the labels refer to is not the same.

    “Both paradigms may label phenomena identically, but in keeping with their paradigmatic assumptions, these labels refer to different things.”
    • Also stated in: § 4. The Phenomenon of Study · boosted
      “These two examples demonstrate that although qualitative and quantitative paradigms may use common labels to refer to phenomena, what the labels refer to is not the same.”
    Quote in the paperSubstantial claim
  • It may state two separate claims as one.

    Interpretationnone given
    § 5. Further Considerations in Mixed-Method Research Designs

    Qualitative researchers have increasingly tried to defend their work using quantitative criteria such as validity and reliability, and increasingly use computer programs for qualitative data in quantitative (counting) ways.

    “In response, qualitative researchers have increasingly tried to defend their work using quantitative criteria, such as validity and reliability, as defined in quantitative studies. They also increasingly use computer programs specifically designed for analysing qualitative data, such as NUD.IST or Ethnograph, in quantitative (counting) ways.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim. It may be too vague to check against evidence. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationnone given
    § 4. The Phenomenon of Study

    Certain phenomena lend themselves to quantitative as opposed to qualitative inquiry and vice versa.

    “It is probably safe to say that certain phenomena lend themselves to quantitative as opposed to qualitative inquiry and vice versa in other instances.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. The paper may give no reason why it holds.

    Interpretationnone given
    § Abstract

    The quantitative and qualitative paradigms have different views of reality.

    “we discuss the implications stemming from our view, that the paradigms upon which the methods are based have a different view of reality and therefore a different view of the phenomenon under study.”
    Quote in the paperNot a substantial claim
  • It may state two separate claims as one.

    Interpretationreasoning
    § 4. The Phenomenon of Study

    The differences in phenomena between the two paradigms are philosophical differences, whereas differences in phenomena within each paradigm are not.

    “However, the differences in phenomena between the two paradigms are philosophical differences, whereas the difference in phenomena within each paradigm are not.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim. It may be too vague to check against evidence.

    Interpretationreasoning
    § 6. Our Solution

    The fact that the approaches are incommensurate does not mean that multiple methods cannot be combined in a single study if it is done for complementary purposes.

    “However, the fact that the approaches are incommensurate does not mean that multiple methods cannot be combined in a single study if it is done for complementary purposes.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. The paper may give no reason why it holds.

    Premisenone given
    § 6. Our Solution

    Quantitative researchers perceive truth as something which describes an objective reality, separate from the observer and waiting to be discovered.

    “Quantitative researchers perceive truth as something which describes an objective reality, separate from the observer and waiting to be discovered.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim.

    Premisecitation
    § 1. Introduction

    Health care research includes many studies that combine quantitative and qualitative methods.

    “Health care research includes many studies that combine quantitative and qualitative methods, as seen in numerous articles and books published in the last decade (Caracelli and Greene, 1993; Caracelli and Riggin, 1994; Casebeer and Verhoef, 1997; Datta, 1997; Droitcour, 1997; Greene and Caracelli, 1997; House, 1994; Morgan, 1998; Morse, 1991; Tashakkori and Teddlie, 1998).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Caracelli and Greene, 1993 source
    • cites Caracelli and Riggin, 1994 source
    • cites Casebeer and Verhoef, 1997
  • Probably not a substantial claim.

    Premisecitation
    § 6. Our Solution

    Qualitative researchers are concerned with the changing nature of reality created through people's experiences - an evolving reality in which the researcher and researched are mutually interactive and inseparable.

    “Qualitative researchers are concerned with the changing nature of reality created through people’s experiences – an evolving reality in which the researcher and researched are mutually interactive and inseparable (Phillips, 1988b).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Phillips, 1988b source
  • Probably not a substantial claim. It may be too vague to check against evidence.

    Interpretationreasoning
    § 4. The Phenomenon of Study

    Combining the two approaches in a complementary fashion is not advisable if the ultimate goal is to study different aspects of the same phenomenon.

    “Combining the two approaches in a complementary fashion is also not advisable if the ultimate goal is to study different aspects of the same phenomenon because, as we argue, mixed-methods research cannot claim to enrich the same phenomenon under study.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim. It may be too vague to check against evidence.

    Interpretationreasoning
    § 7. Implications

    This solution lends itself to new standards for mixed-paradigm research.

    “This solution lends itself to new standards for mixed-paradigm research.”
    Quote in the paperNot a substantial claim
  • It may state two separate claims as one.

    Interpretationreasoning
    § 5. Further Considerations in Mixed-Method Research Designs

    The common design of a qualitative pilot followed by quantitative research promotes the mis-perception that qualitative research is only exploratory, cannot stand on its own, and must be validated by quantitative work because the latter is "scientific" and studies truth.

    “This promotes the mis-perception that qualitative research is only exploratory, cannot stand on its own, and must be validated by quantitative work because the latter is “scientific” and studies truth.”
    Quote in the paperSubstantial claim
  • It may state two separate claims as one.

    Premisecitation
    § 2. The Two Paradigms

    In the quantitative paradigm, the investigator and investigated are independent entities, so the investigator can study a phenomenon without influencing it or being influenced by it.

    “Epistemologically, the investigator and investigated are independent entities. Therefore, the investigator is capable of studying a phenomenon without influencing it or being influenced by it; “inquiry takes place as through a one way mirror” (Guba and Lincoln, 1994: 110).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Guba and Lincoln, 1994

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.

    Interpretationnone given
    § 4. The Phenomenon of Study

    Both quantitative and qualitative researchers often appear to study the same phenomena, but their definitions of what the phenomena are and how they can best be described or known differ.

    “Both quantitative and qualitative researchers often appear to study the same phenomena. However, these researchers’ definition of what the phenomena are and how they can best be described or known differ.”
    Quote in the paperNot a substantial claim
  • It may state two separate claims as one.

    Interpretationreasoning
    § 4. The Phenomenon of Study

    Cross-validation and complementarity in the context of studying the same phenomenon violate paradigmatic assumptions and misrepresent data.

    “Not only does cross-validation and complementarity in the above context violate paradigmatic assumptions, but it also misrepresents data.”
    Quote in the paperNot a substantial claim
32 of 32
  • The paper relies on this without support.

    Mixed-methods research is now being adopted uncritically by a new generation of researchers who have overlooked the underlying assumptions behind the qualitative-quantitative debate.

    “We believe that mixed-methods research is now being adopted uncritically by a new generation of researchers who have overlooked the underlying assumptions behind the qualitative-quantitative debate.”
  • The paper relies on this without support.

    One cannot be both a positivist and an interpretivist or constructivist.

    “We believe, however, that one cannot be both a positivist and an interpretivist or constructivist.”
  • The paper relies on this without support.

    The inherent differences between the quantitative and qualitative paradigms rarely are discussed or acknowledged by those using mixed-method designs.

    “The inherent differences rarely are discussed or acknowledged by those using mixed-method designs.”
  • The paper relies on this without support.

    The positivist paradigm has become the predominant frame of reference in the physical and social sciences.

    “The reasons why may be because the positivist paradigm has become the predominant frame of reference in the physical and social sciences.”
  • The paper relies on this without support.

    Research methods are presented as not belonging to or reflecting paradigms.

    “In addition, research methods are presented as not belonging to or reflecting paradigms.”
  • The paper relies on this without support.

    Pressure is being exerted from the quantitative camp for qualitative research to “measure up” to its standards without understanding the basic premises of qualitative investigations.

    “Pressure is being exerted from the quantitative camp for qualitative research to “measure Up” to its standards without understanding the basic premises of qualitative investigations.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In syndemics research, key aspects such as context likely attract contrasting conceptualizations and operationalizations across disciplines.

    “In syndemics research, key aspects, such a context, likely attract contrasting conceptualizations and operationalizations across disciplines [ 4 , 12 ].”

    From Syndemic contexts: findings from a review of research on non-communicable diseases and interviews with experts (2021) · cites this paper as [12]

    Section 4, “The Phenomenon of Study” (page unavailable), says quantitative and qualitative researchers may use the same label while defining and studying the phenomenon differently. That supports the general point about contrasting conceptualizations and approaches, but the paper does not address syndemics, context specifically, or differences across disciplines. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • 1995 cited author's name differs from the reference

    Minor

    The in-text citation names "Secker," but the matching 1995 reference lists "Seeker."

  • 1986 coauthor's name is spelled two ways

    Minor

    The in-text citation spells the coauthor's name "Heshius," while the corresponding 1986 reference spells it "Heshusius."

2 of 2

Citations

Cites

Flagged first, then by citations

4 of the 53 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. Reid, A. J. (1996). What we want: Qualitative research. Canadian Family Physician 42: 387-389.

Cited by

Sorted by citations

Metadata

Authors
Sale, J. E. M., Lohfeld, L. H., & Brazil, K.
Affiliations
  • Institute for Work & Health (CA)
  • St. Joseph's Hospital (CA)
Corresponding author
Sale, Joanna E. M.
Venue
Quality and Quantity
Published
2002-02
Volume
36
Issue
1
Pages
43-53
ISSN
  • 0033-5177 (ISSN-L)
  • 1573-7845
OpenAlex
W1584545958
Cited by
1,082
References
53
Citations by year
2026: 12 · 2025: 24 · 2024: 25 · 2023: 34 · 2022: 38 · 2021: 49 · 2020: 67 · 2019: 58 · 2018: 59 · 2017: 66 · 2016: 68 · 2015: 80 · 2014: 110 · 2013: 89 · 2012: 54
FWCI
40.37
Type
journal article
Language
en
Open access
Locations
  • Quality & Quantity (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • Research Portal (Queen's University Belfast) (submittedVersion)
Funders
Canadian Institutes of Health Research (40723_1)
Topics
  • Social Sciences › Education › Educational Research and Methods
  • Social Sciences › Education › Qualitative Research Methods and Applications
  • Social Sciences › Business, Management and Accounting › Strategy and Management › Business Strategies and Management Research
Keywords
mixed methods, research paradigms, triangulation, cross-validation, health care research, research standards

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