Conduct qualitative meta-synthesis and evidence synthesis methods
A skill for conducting qualitative meta-synthesis -- the systematic integration of findings across multiple qualitative studies. Covers meta-ethnography (Noblit & Hare), thematic synthesis (Thomas & Harden), framework synthesis, and quality appraisal of qualitative studies.
Meta-synthesis is to qualitative research what meta-analysis
is to quantitative research -- it systematically combines
findings from multiple studies to produce higher-order
interpretations.
Key differences from meta-analysis:
- Interpretive, not statistical aggregation
- Aims to generate new understanding, not average effect sizes
- Synthesizes themes, concepts, and metaphors across studies
- Product is a new interpretation, not a pooled statistic
Appropriate when:
- Multiple qualitative studies exist on a topic
- You want to build theory or deepen understanding
- Individual studies have limited scope but collectively cover a phenomenon
- Policy or practice needs an integrated evidence base from qualitative work
Not appropriate when:
- Studies are too heterogeneous in topic to meaningfully compare
- Fewer than 3 qualitative studies exist
- The goal is to measure effect sizes (use meta-analysis instead)
def meta_ethnography_steps() -> dict:
"""
The seven steps of meta-ethnography (Noblit & Hare, 1988).
"""
return {
"step_1_getting_started": {
"description": "Identify the research question and intellectual interest",
"output": "Clear synthesis question"
},
"step_2_deciding_what_is_relevant": {
"description": "Systematic search and selection of qualitative studies",
"output": "Final set of included studies",
"note": "Use PRISMA flow diagram to document selection"
},
"step_3_reading_the_studies": {
"description": (
"Read and re-read included studies carefully. "
"Identify key metaphors, themes, and concepts in each."
),
"output": "List of first-order (participant quotes) and "
"second-order (author interpretations) constructs"
},
"step_4_determining_how_studies_are_related": {
"description": (
"Create a grid mapping constructs across studies. "
"Determine if studies are reciprocal (about similar things), "
"refutational (contradictory), or form a line of argument."
),
"output": "Construct comparison table"
},
"step_5_translating_studies": {
"description": (
"Translate the concepts of one study into the terms of another. "
"This is the core analytical step -- finding common meaning "
"expressed in different language."
),
"output": "Translated constructs across all studies"
},
"step_6_synthesizing_translations": {
"description": (
"Develop third-order constructs -- new interpretations "
"that go beyond what any single study found."
),
"output": "Third-order constructs (the synthesis)"
},
"step_7_expressing_the_synthesis": {
"description": "Write up the synthesis in a form accessible to the audience",
"output": "Published meta-synthesis paper"
}
}
Reciprocal translation:
Studies are about similar things. Translate them into each other.
"Study A calls it 'navigating uncertainty'; Study B calls it
'managing ambiguity'; Study C calls it 'living with not knowing'.
The overarching construct is 'Tolerating the Unknown.'"
Refutational synthesis:
Studies contradict each other. Explore why.
"Study A found empowerment through peer support; Study B found
peer support increased anxiety. This refutation may be explained
by the stage of illness at which support was received."
Line of argument synthesis:
Studies address different aspects that together form a whole.
"Study A covers diagnosis, B covers treatment, C covers recovery.
Together they reveal a trajectory of 'Reconstructing Identity.'"
Stage 1: Free coding of findings
- Treat the findings sections of included studies as data
- Code them line by line, as in primary qualitative analysis
Stage 2: Organizing codes into descriptive themes
- Group codes into descriptive themes
- These are "close to" the original studies
Stage 3: Generating analytical themes
- Go beyond the content of the original studies
- Generate new interpretive constructs
- Answer the synthesis research question
Tools for appraising qualitative study quality:
CASP Qualitative Checklist (10 items):
- Was there a clear statement of aims?
- Is a qualitative methodology appropriate?
- Was the research design appropriate?
- Was the recruitment strategy appropriate?
- Was data collected in a way that addressed the research issue?
- Was the relationship between researcher and participants considered?
- Were ethical issues considered?
- Was data analysis sufficiently rigorous?
- Was there a clear statement of findings?
- How valuable is the research?
JBI Checklist for Qualitative Research (10 criteria)
Decision: Include all studies or exclude low-quality studies?
- Sensitivity analysis: Run the synthesis with and without
lower-quality studies to see if conclusions change.
Use the ENTREQ (Enhancing Transparency in Reporting the Synthesis of Qualitative Research) statement. Report: the synthesis methodology used, the search strategy and selection criteria, quality appraisal results, a table of included studies with their key constructs, the synthesis process with clear evidence trails, and how third-order constructs were derived from the primary studies.