Quality & Quantity 38: 351–365, 2004.
© 2004 Kluwer Academic Publishers. Printed in the Netherlands.
A Strategy to Identify Critical Appraisal Criteria for
Primary Mixed-Method Studies
JOANNA E. M. SALE
Health Research Methodology, Faculty of Health Sciences, McMaster University, 1280 Main St. W,
Hamilton, ON L8N 1G8
Clinical Epidemiology and Biostatistics, Faculty of Health Sciences, McMaster University, 105
Main St. E., Level P1 Hamilton, ON L8N 1G8
Abstract. The practice of mixed-methods research has increased considerably over the last 10
years. While these studies have been criticized for violating quantitative and qualitative paradig-
matic assumptions, the methodological quality of mixed-method studies has not been addressed.
The purpose of this paper is to identify criteria to critically appraise the quality of mixed-method
studies in the health literature. Criteria for critically appraising quantitative and qualitative studies
were generated from a review of the literature. These criteria were organized according to a cross-
paradigm framework. We recommend that these criteria be applied to a sample of mixed-method
studies which are judged to be exemplary. With the consultation of critical appraisal experts and
experienced qualitative, quantitative, and mixed-method researchers, further efforts are required to
revise and prioritize the criteria according to importance.
Key words: mixed methods, multiple methods, qualitative methods, quantitative methods, critical
The practice of mixed-methods research has increased considerably over the last
10 years, as seen in numerous articles, chapters, and books published (Caracelli
and Greene, 1993; Carcelli and Riggin, 1994; Casebeer and Verhoef, 1997; Datta,
1997; Droitcour, 1997; Greene and Caracelli, 1997; House, 1994; Morgan, 1998;
Tashakkori and Teddlie, 1998). Journal series have been devoted to this topic as
well (see Volume 19 of Health Education Quarterly (1992); Number 74 of New
Directions for Evaluation (1997); Volume 34 of Health Services Research (1999)).
Despite being criticized for violating quantitative and qualitative paradigmatic
assumptions, the methodological quality of mixed- method studies has not been ex-
amined. While one could argue that the quality of mixed-method studies cannot be
assessed until the quantitative-qualitative philosophical debate is resolved, it will
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