It Takes Two: An Argument for Mixed Methodology in Epilepsy Health Disparities Research
In recent decades, neurologists have been directing more of their research efforts to exploring the sources of health disparities in medical and surgical treatment of epilepsy. Many studies reveal that racial and ethnic minority patients continue to receive suboptimal care, which has some dire repercussions on their physical and mental health, as well as their social wellbeing because epilepsy is a chronic disease that tends to affect multiple aspects of the patient’s life. Although the earliest landmark studies emphasized the importance of mixed methodology research, the studies that followed tended to rely heavily on quantitative methods to unravel patterns of disparities with sparse use of qualitative methods to give voice to the patients concerned. In this work, I present a mixed methodology framework that is particularly suitable to investigating health disparities in epilepsy care, which affirms the complementary nature of quantitative and qualitative methods. I explore some of the challenges that clinicians face to utilizing qualitative methods, and introduce some of the validity criteria and techniques of qualitative research that make it a valuable methodology to understand disparities. I highlight some of the ethical concerns with recent studies in health disparities in epilepsy care which adopt only quantitative or qualitative methodology, and contribute very little to eliminating disparities compared to the potential contribution of mixed methodology research. This will be supported by various examples from research led by clinicians, public health professionals, and social scientists.