Report on methodological quality assessment of primary care and general practice research in China in 2021:Qualitative and mixed methods research section

Background: General practice, with its interdisciplinary nature, is well-suited to both qualitative and mixed-methods research. In recent years, the number of relevant academic publications in China has steadily increased, yet the overall quality has not been systematically assessed. Objective: This study aims to evaluate the methodological quality of qualitative and mixed-methods studies published in the field of primary care and general practice in China. Methods: From August 2022 to April 2023, four investigators analyzed and assessed the methodological quality of qualitative and mixed methods research published in the field of primary care and general practice in China in 2021 using the qualitative assessment tools of Critical Appraisal Skills Programme(CASP) and Mixed Methods Appraisal Tool(MMAT), respectively. The researchers worked in pairs, independently conducting data extraction and quality evaluation. Results: A total of 35 qualitative research and 9 mixed methods research were included. Key issues in qualitative studies included: insufficient attention to ethical considerations (65.71 %, 23/35), lack of discussion on participant recruitment (94.29 %, 33/35), limited consideration of the researcher-participant relationship (82.86 %, 29/35), sample sizes of <20 participants in 42.86 % (15/35) of studies, and lack of data saturation discussion in 25.71 % (9/35). Major issues in mixed-methods studies included a lack of clarity in research design type (8/9 studies) and ineffective integration of qualitative and quantitative components to answer the research question (8/9 studies). Conclusion: The methodological quality of such qualitative and mixed methods research in primary care and general practice published in 2021 in China is still partially limited, especially in the areas of ethics, reliability, and data saturation in qualitative studies and integration of methods in mixed-methods research. Improved training in research methodology and adherence to design and reporting standards are essential to enhance the quality of future research and the robustness of evidence generated for decision-making.