Abstract
<jats:p>Background: Qualitative interview studies are a cornerstone of health and social science research, but manual analysis is time-intensive and difficult to scale, particularly in larger datasets. While Large Language Models (LLMs) offer new opportunities, concerns about transparency, reproducibility, and methodological validity have limited their scientific adoption. Objectives: We present a four-stage LLM pipeline comprising segmentation, coding, concept development, and quote extraction, designed to replicate expert-driven qualitative analysis with a complete, auditable analysis trail. Methods: The pipeline was applied to 28 semi-structured interview transcripts on health data donation and evaluated by five researchers who conducted the original manual analysis using the QUEST framework. Results: The pipeline produced 12 higher-level and 73 lower-level concepts in 45 minutes, demonstrating substantial efficiency gains compared to manual analysis. Expert assessment confirmed high content validity, strong thematic overlap with manual results, and all outputs traceable to source text. The majority of evaluators deemed outputs suitable for scientific use following minor revisions. Conclusion: LLM-assisted qualitative analysis, embedded in a transparent pipeline and subject to expert oversight, interpretation and contextualisation, can produce verifiable, high-quality results and substantially enhance the scalability of qualitative research.</jats:p>