Perspective

Thematic analysis and its reconceptualization

as ‘saliency analysis’

Stephen Buetow
Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand

Thematic analysis is characteristic of most qualitative research. Themes are groups of codes that recur through
being similar or connected to each other in a patterned way. Thematic analysis ignores codes that do not recur yet
may nonetheless be important. This paper proposes the concept of ‘saliency analysis’ as an enhancement of
thematic analysis. Saliency analysis assesses the degree to which each code recurs, is highly important or
both. Codes of high importance are ones that advance understanding or are useful in addressing real world
problems, or both. Thus saliency analysis can expose what is non-recurrent but potentially important to the
aims of a study.
Journal of Health Services Research & Policy Vol 15 No 2, 2010: 123 –125 # The Royal Society of Medicine Press Ltd 2010

Thematic analysis is one of the first analytic techniques
that most qualitative researchers learn, but there is
no clear agreement about what it entails.1 It survives
as a ‘poorly demarcated and rarely acknowledged, yet
widely used qualitative analytic method’.1 It attempts
in general to reveal core consistencies and meanings in
a text by identifying and analysing themes, which are
large, abstract categories2 of meaningful data segments.
In themes, these segments, which are known as codes,
recur in the broad sense that repeated codes are similar
or connected to each other in a patterned way.
Recurrence can take place across or within cases, such
as persons, groups, events or processes.3
Contrary to some claims,4 however, the mere recur-
rence of codes is not necessarily a sufficient criterion
of their importance (as defined below).1 Statements
‘about how many people have said something’ can be
‘tedious to read’ and leave readers unsure how to inter-
pret the numbers.5 Reliability is also a contested cri-
terion for establishing the truth of qualitative accounts
or interpretations, for example between data ana-
lysts.6 – 8 Different researchers may offer different, sub-
jectively real accounts, each of which has some ‘validity’.
Recurrence can be especially challenging to detect
when ‘thematic analysis . . . occurs when all the data
are in’; and the importance of particular data excerpts
Stephen Buetow PhD, Department of General Practice and Primary
Health Care, University of Auckland, Private Bag 92019, Auckland
Mail Centre, Auckland 1142, New Zealand.
Correspondence to: s.buetow@auckland.ac.nz
was not detected during a ‘critically reflective process
of preliminary data analysis’.9 It may not be feasible to
return to the field, re-interview the same participant
or interview additional participants, or to re-code into
themes the non-themes that are very dissimilar from
the themes identified. Re-coding of the data, even
when it is possible, may make meanings more abstract
than they were, merely for the sake of achieving conver-
gence and recurrence.
Against this backdrop, thematic analysis tends to con-
flate two concepts: recurrence and importance.
Moreover, codes that do not recur – however important
they may be – cannot, by definition, be thematic. Those
that are exceptions to possible themes are only used to
scrutinize and revise these themes. Since even single
codes may be important and transferable to other set-
tings,10 capturing information about their significance
requires distinguishing the importance of the codes
from their frequency of common or related occurrence.
This paper therefore attempts to conceptualize saliency
analysis as a new analytic approach that can meet these
needs through refinement of thematic analysis.
Saliency analysis
Saliency analysis identifies and keeps visible what stands
out from qualitative data. It highlights which units of
meaning are salient at the data surface ( primary sa-
lience) while also exposing the salience of latent mess-
ages (secondary salience). It thereby aims to facilitate
clarity and the production of salient conclusions.11

DOI: 10.1258/jhsrp.2009.009081
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Perspective
Saliency analysis first assesses from the data the degree
to which each code recurs, or is highly important or
has both attributes.
The concept of ‘importance’ is widely agreed for eval-
uating qualitative research,7 yet its meaning is elusive.
For the purpose of this description of saliency analysis,
findings are highly important when they are new and
advance understanding, are useful in addressing real
world problems, or do both.12,13 Although it may be
irrelevant whether, say, six compared with nine partici-
pants make a similar observation, a relatively high fre-
quency may also signify the importance of a finding.
Importance further depends on what an analysis
shows and does not show in relation to the study ques-
tion, as interpreted within action-guiding norms.5 The
discussion should be sufficiently detailed to allow
readers to check the interpretation.
Operationally, saliency analysis first assesses, in any
order, the recurrence and importance of each code
and designates it as one of the following: (1) highly
important and recurrent; (2) highly important but not
recurrent; (3) not highly important but recurrent; (4)
not highly important and not recurrent. Cells 1 to 3 of
this matrix highlight the salient codes at or beneath
the data surface. Collapsing the cells loses information
however, so researchers are likely instead to cycle back
and forth between the individual cells, which add infor-
mation, and some aggregated whole, such as either all
the salient cells or all four cells.
The cells will be comprised fundamentally of codes.
To reduce the number and complexity of these codes,
and to reveal their interrelationships, saliency analysis
secondly considers how the codes may converge to
produce themes within cell 1 and cell 3. This process
reveals whether the themes in these cells are highly
important or not. It resembles the distinction sometimes
made between dominant themes and other themes,14,15
but it relates this distinction explicitly to the degree of
importance of the themes. By keeping the codes and
themes salient, it also shows how these forms of data
interrelate and cannot be understood without reference
to each other and some whole of which they form part.
Consider, for example, two heart failure patients who
report that (a) a clinician had not told them they had
‘heart failure’ until (b) they had discovered this malig-
nant diagnosis for themselves by reading their prescrip-
tion or pill bottle.16 The codes describing (b) are highly
important and can be summarized in cell (1) by a theme
such as ‘accidental discovery of heart failure’. This new,
recurrent finding has implications for safe information-
giving to patients by clinicians concerning a diagnosis of
heart failure. The importance of the codes describing (a)
are secondary to (b) and can fit in cell (3) under a label
such as ‘diagnosis-giving’.
Thirdly, cell 2 keeps salient the highly important
codes that do not converge into themes. It protects
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Thematic analysis and its reconceptualization as ‘saliency analysis’
against the loss of these codes and against over-
stretching any themes in order to accommodate them.
An example of a highly abstract and imprecise theme
is what Juilliard et al. 17 labelled the ‘physician –patient
relationship’. Cell 2 could also expose conspicuously
absent information that is potentially important but
does not constitute an explicit theme.
Imagine, for example, a study to elucidate barriers to
accessing mental health services. Participants might
report feeling stigmatized without attributing this
feeling to discrimination. Their silence may be impor-
tant but not be documented as a theme, in the context
of other research indicating such a relationship.
Similarly, if one participant mentions discrimination
once, this finding is not thematic, but may be sufficiently
important to include in cell 2.
The analysis of saliency is further informed by, and
informs, a salient mode of concurrent data collection,
on the basis of which feedback can be iteratively provided
to the researcher from an early stage in the study. This
feedback guides the further collection of data in ways
that can facilitate exposure of what is recurrent, impor-
tant, or both, in relation to the study phenomenon.
Strategies to gather such data will vary with each study
but could include: selecting some participants who can
represent idiosyncratic and uncommon perspectives;
exploring the study phenomenon as lived by participants
in particular circumstances; and eliciting participants’
direct judgments of the recurrence and relative impor-
tance of the content of their reported accounts. For
example, to find out the most important barriers to
patient medication adherence, a question asked of each
sampled, non-adherent patient could be ‘what one
thing most stops you from taking your pills?’
Saliency analysis concludes by using the four categories
to structure reporting of the final findings in a salient
manner. Visual representations, such as a tabular
summary,14 can map themes, their constituent codes,
and non-thematic codes against this structure. For
example, recurrent but not highly important content
can signify minor themes that clarify and emphasize
major themes. The main text can then ‘grow’ a discussion
of selected content to elaborate on how the whole and its
parts are best understood through reference to each other.
Conclusion
Thematic analysis is a commonplace but poorly defined
and incomplete route to understanding the importance
of coded excerpts, including those that do not recur.
Saliency analysis enhances thematic analysis by explicitly
considering both the recurrence and importance of
individual codes. These distributions can make salient,
and structure an analysis of, the themes derived from
codes, and the codes that are non-thematic.
2010Library @ Thomas Jefferson University on December 24, 2014
Thematic analysis and its reconceptualization as ‘saliency analysis’
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