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Even if you never intend to run a randomized trial, being familiar with their strengths and weaknesses maximizes impact across disciplines. Smith-Morris and colleagues (2014) describe a collaboration in which ethnography was built into a randomized clinical trial. Their experience highlighted the complementarity of approaches and suggested a need for “more clinical and trial-based applications of medical anthropology” (p. 157).

Observational Designs Most research in medical anthropology, as in other health-related social sciences, is observational. Observational studies lack the defining features of experiments – random assignment to comparison groups and control over independent variables – and so are not well suited to demonstrate causal effects. But they are preferable to experiments for exploratory questions and have other advantages in confirmatory research, including higher external validity (generalizability), greater feasibility, and often fewer ethical objections.

We can distinguish three broad classes of observational designs: cross-sectional, longitudinal, and case-control studies (Figure 4.4). These three types of studies are recognized as the basic design options in epidemiology and biomedical sciences, but they are also used to varying degrees in medical anthropology. Cross-sectional studies, in which data are collected during one point in time, are the most common type. Although data collection often lasts for months or years, the study is still considered cross-sectional if the data are taken to represent one point in time. Thus, even long-term ethnographic research is usually cross-sectional in design (Gravlee et al. 2009).