Epistemic Culture

Epistemic culture is a primary driver of variation, with nephrology and haematology historically centred on biomarkers and quantifiable endpoints that privilege quantitative methodologies. Infectious diseases' frequent engagement with psychosocial and behavioural dimensions — including stigma, treatment adherence, and health-seeking behaviour — makes it a natural fit for qualitative exploration. A shortage of reviewers with qualitative methods expertise reduces publication opportunities and entrenches quantitative dominance through a self-reinforcing cycle. Limited qualitative methods expertise, mentorship, and institutional support create practical barriers to conducting and publishing qualitative work in certain subspecialties. Longstanding editorial misconceptions about the limited practical value or lower citation rates of qualitative research have been documented in high-impact journals, despite evidence to the contrary.