Nursing Resource Guide

A meta-synteses is bringing together qualitative data to form a new interpretation of the research field.  It helps to build new theories and is not to be confused with a meta-analysis which tests a hypothesis using quantitative data.  It primarily generates theory such as program theory, implementation theory, or an explanatory theory of why the intervention works or not, hypothesis for future testing or comparison with trial outcomes.

Meta-syntheses are best designed for:

• To re-interpret meaning across many qualitative studies.

(Source:  S. Atkins et al (2008))

Timeframe: 12+ months or less.   *Varies beyond the type of review. Depends on many factors such as but not limited to: resources available, the quantity and quality of the literature, and the expertise or experience of reviewers" (Grant et al. 2009)

Question:  May use PICo (Population, Interest, Context), SPICE, SPIDER or PerSPEcTiF question formats, "A clearly formulated question helps to set boundaries for the scope and depth of a meta-ethnography" (Atkins S.)

Sources and searches: 

Refer to the 7 S Framework of Qualitative Searching by Booth (2016) https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-016-0249-x

Search specifically for qualitative studies, may include more grey literature, book chapters or conference proceedings or theses. 

Selection: Different screening process--includes repeated reading of articles to connect and record concepts or themes. 

Appraisal: Focus is on the translation of studies and then systematically compared or 'translated' within and across studies while retaining the structure of the relationships between central concepts/themes and includes a 'thematic analysis'.

Synthesis: Qualitative Differs from a Meta-Analysis (Quantitative) "The goal is not aggregative in the sense of 'adding studies together' as with a meta-analysis.  On the contrary, it is interpretative in broadening understanding of a particular phenomenon." (Source: Grant et al (2009))

There are 3 types of synthesis that may be used.  A second level of synthesis is possible.

1. Reciprocal Translation: Concepts in one study can incorporate those of another.
2. Refutational Translation: Concepts in different studies contradict one another.
3. Line of Argument Synthesis: Studies identify different aspects of the topic that can be drawn together in a new interpretation.

(Source: France EF, Ring N et al (1988))

For more about the reporting guidelines for a Meta-Synthesis or Meta-Ethnography please visit the eMERGe Project website at http://emergeproject.org/ and ENTREQ for the reporting of qualitative evidence syntheses. 

There is also the Cochrane Qualitative & Implementation Methods Group: http://methods.cochrane.org/qi/