Group concept mapping as a mixed-methods approach for integrating patient voices in participatory health research: ethical and practical considerations

Patient-oriented and community-based participatory research emphasize partnership, shared power, and the meaningful inclusion of patient and community knowledge in health research. Group Concept Mapping (GCM) is a structured mixed-methods methodology that combines qualitative idea generation with quantitative analysis and visual mapping. Although GCM is participatory in design, its patient-centric value depends on how ethically the method is implemented, who is involved, and how findings are interpreted and used. This paper critically examines GCM as a methodological tool for integrating patient voices in participatory health research. We describe the six phases of GCM, including preparation, idea generation, structuring, representation, interpretation, and utilization, and analyze how each phase can support or constrain patient-centric, community-based participatory research (CBPR), and patient-oriented research (POR) principles. We also explain ethical and practical considerations related to recruitment, facilitation, accessibility, statement reduction, representation, digital participation, participant burden, and utilization. GCM can support collective sense-making, shared problem definition, prioritization, and action-oriented planning by engaging patients, community members, researchers, clinicians, and decision-makers in a structured process. Its visual maps can make complex patient- and community-generated knowledge accessible for intervention development, program planning, evaluation, and policy discussion. However, GCM is not inherently patient-centric. Its value depends on intentional design, meaningful representation of lived experience, culturally safe facilitation, transparent analytic decisions, shared interpretation, and accountable use of findings. GCM offers a promising methodological pathway for integrating patient and community voices into participatory health research, but it should not be treated as automatically aligned with CBPR or POR principles. Its capacity to advance patient-centric research depends on the ethical and epistemological commitments guiding its implementation, including shared power, reflexivity, inclusion, and follow-through. When implemented with these conditions, GCM can generate culturally grounded, socially just, and actionable insights for healthcare planning, intervention development, and policy.