#2922 The relative and absolute quantity of qualitative research in nephrology compared to other specialities: a scoping review covering over two decades

Abstract

Abstract Background and Aims Qualitative research provides invaluable insights into patient experiences, clinical perspectives and the complexities of care processes. It has the potential to transform clinical practice, enhance patient-centred care, and improve health outcomes. Yet, the speed and scale of adoption in nephrology compared to other medicine clinical specialities remains undefined. Method Three databases were systematically searched using speciality-specific terms for 12 medical specialities, including nephrology, to estimate absolute and relative numbers of qualitative studies between 01/01/2000 and 31/12/2024. The speciality-specific impact of COVID-19 on the results necessitated the exclusion of COVID-19 studies. A follow-up search was conducted to explore the number of qualitative studies in 10 nephrology subspecialities. Quality assessment was conducted on 100 randomly selected nephrology qualitative studies using the Joanna Briggs Institute Critical Appraisal Tool for Qualitative Research. Results Between Jan 2000 and Dec 2024, 1,608,917 studies were retrieved, of which 17,533 were qualitative. Each of the other medical specialities had a higher number of qualitative studies, ranging from 35,787 in haematology to 135,909 in neurology. There was statistically significant variation between the speciality and the proportion of qualitative studies (P < 0.001). The proportion of studies that were qualitative across all specialties was 1.62% (95% CI: 1.61%–1.63%), with nephrology significantly lower at 1.09% (95% CI: 1.07%–1.11%). In comparison, the proportion of qualitative studies in other specialities ranged from 1.08% in haematology (95% CI: 1.07%–1.09%) to 4.56% in infectious diseases (95% CI: 4.53%–4.60%). The proportion of qualitative studies in nephrology increased from 0.49% in 2000 to 1.78% in 2024 (1.29% absolute increase). This increase was below the rise in proportion of qualitative results across all the specialities, which grew from 0.87% in 2000 to 2.49% in 2024 (1.62% absolute difference). Nephrology subspeciality was identified for 15,942 studies (91%). Chronic kidney disease had the highest number of qualitative results at 6,092 compared to acid-base imbalances at 440. The overall proportion of studies that were qualitative across nephrology subspecialities was 1.17%, ranging from 0.57% in acute kidney injury (95% CI: 0.53%–0.61%) to 1.98% in peritoneal dialysis (95% CI: 1.84%–2.11%). While quality assessments demonstrated a strong alignment between research methodology and objectives in nephrology qualitative studies, key elements such as reflexivity (self-examination of researcher influence) and transparency (explicit documentation of research processes) were often lacking. Conclusion Despite evidence that patient experience and care processes are crucial for achieving positive patient outcomes in nephrology, the low absolute and relative number of qualitative results is concerning. This paucity hinders the nephrology community's efforts to fully understand and respond effectively to the complex challenges faced by patients. Although some nephrology subspecialities have shown greater adoption of qualitative methodologies, greater uptake in larger subspecialities such as acute kidney injury may be needed for nephrology to compete with other specialities.

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