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In considering the place of incident monitoring in the overall scheme of things, one is reminded of Peter Ustinov's anecdote about his father who is reported to have enjoyed entertaining the fairer sex; he was “ . . . always galloping, like a daring scout, in the no-man's-land between wit and poor taste”.1 Promoting incident monitoring to one's scientific colleagues is an analogous activity. Like telling a risque story, it can be enjoyable and may yield unexpected, interesting outcomes; however it is, at least at the moment, only marginally respectable.
Despite widespread reservations about its pedigree, incident monitoring is classical qualitative research, with attributes and limitations which are familiar to social scientists. Many biomedical scientists dismiss activities which cannot capture a numerator and a denominator, but in doing so, may constrain their horizons and limit the scope of their research. Indeed, some of our colleagues simply sit back and enjoy the status quo, comfortable with conventional dogma and the knowledge that it cannot easily be challenged using conventional quantitative techniques.
Quantitative methods have been the mainstay of traditional biomedical research. There is no doubt that the “gold standard” for establishing the efficacy or applicability of a treatment or technique is a randomized, prospective, double blind study; ideally, all new forms of medical treatment and, indeed, all existing forms, should be subjected to such scrutiny. However, there are frequently great difficulties pursuing this course—logistic, political, financial and ethical. Studies may be carried out using quantitative methods of less rigour, but the possibility of erroneous conclusions increases the further one moves from the classical prospective study. All too often, nothing is done at all, with the result that much of our professional activity continues to be empirically based. There are some constraints which are peculiar to quantitative research. An a priori …
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