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Qualitative Evidence Synthesis

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Patient Involvement in Health Technology Assessment

Abstract

Qualitative evidence synthesis, also known as qualitative systematic review, offers a vehicle for presenting patients’ attitudes, beliefs and feelings as originally captured by individual qualitative research studies. By aggregating or integrating views from multiple studies, rather than a single study, the science of systematic reviews takes steps to protect against allowing findings from an isolated study to overly influence our understanding or even to lead us to omit important perspectives. This chapter examines the wide range of uses to which qualitative evidence synthesis can be applied within HTA (Ring et al., Int J Technol Assess Health Care 27:384–390, 2011a; http://www.nhshealthquality.org/nhsqis/8837.html. Accessed 8 Apr 2016, 2011b) and introduces methods to identify, synthesise and analyse patient narratives from the research literature. The chapter concludes by briefly reviewing methods by which qualitative data might be integrated with quantitative data from an effectiveness review.

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References

  • Alexander J. Patients’ feelings about ward nursing regimes and involvement in rule construction. J Psychiatr Ment Health Nurs. 2006;13:543–53.

    Article  CAS  PubMed  Google Scholar 

  • Barnett-Page E, Thomas J. Methods for the synthesis of qualitative research: a critical review. BMC Med Res Methodol. 2009;9:59.

    Article  PubMed  PubMed Central  Google Scholar 

  • Baxter SK, Blank L, Woods HB, Payne N, Rimmer M, Goyder E. Using logic model methods in systematic review synthesis: describing complex pathways in referral management interventions. BMC Med Res Methodol. 2014;14:62.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bélanger E, Rodríguez C, Groleau D. Shared decision-making in palliative care: a systematic mixed studies review using narrative synthesis. Palliat Med. 2011;25:242–61.

    Article  PubMed  Google Scholar 

  • Benoot C, Hannes K, Bilsen J. The use of purposeful sampling in a qualitative evidence synthesis: a worked example on sexual adjustment to a cancer trajectory. BMC Med Res Methodol. 2016;16:21.

    Article  PubMed  PubMed Central  Google Scholar 

  • Boote J, Baird W, Sutton A. Involving the public in systematic reviews: a narrative review of organizational approaches and eight case examples. J Compar Eff Res. 2012;1:409–20.

    Article  Google Scholar 

  • Booth A. Searching for qualitative research for inclusion in systematic reviews: a structured methodological review. Syst Rev. 2016;5:74.

    Article  PubMed  PubMed Central  Google Scholar 

  • Booth A, Carroll C. How to build up the actionable knowledge base: the role of ‘best fit’ framework synthesis for studies of improvement in healthcare. BMJ Qual Saf. 2015a;24:700–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Booth A, Carroll C. Systematic searching for theory to inform systematic reviews: is it feasible? Is it desirable? Health Info Libr J. 2015b;32:220–35.

    Google Scholar 

  • Booth A, Carroll C, Ilott I, Low LL, Cooper K. Desperately seeking dissonance: identifying the disconfirming case in qualitative evidence synthesis. Qual Health Res. 2013a;23:126–41.

    Article  PubMed  Google Scholar 

  • Booth A, Harris J, Croot E, Springett J, Campbell F, Wilkins E. Towards a methodology for cluster searching to provide conceptual and contextual “richness” for systematic reviews of complex interventions: case study (CLUSTER). BMC Med Res Methodol. 2013b;13:118.

    Article  PubMed  PubMed Central  Google Scholar 

  • Booth A, Noyes J, Flemming K, Gerhardus A, Wahlster P, Van Der Wilt GJ, et al. Guidance on choosing qualitative evidence synthesis methods for use in health technology assessments of complex interventions. INTEGRATE-HTA. 2016. Available: http://www.integrate-hta.eu/wp-content/uploads/2016/02/Guidance-on-choosing-qualitative-evidence-synthesis-methods-for-use-in-HTA-of-complex-interventions.pdf. Accessed 8 Apr. 2016.

  • Brunton G, O’Mara-Eves A, Thomas J. The ‘active ingredients’ for successful community engagement with disadvantaged expectant and new mothers: a qualitative comparative analysis. J Adv Nurs. 2014;70:2847–60.

    Google Scholar 

  • Candy B, King M, Jones L, Oliver S. Using qualitative synthesis to explore heterogeneity of complex interventions. BMC Med Res Methodol. 2011;11:124.

    Article  PubMed  PubMed Central  Google Scholar 

  • Carroll C, Booth A. Quality assessment of qualitative evidence for systematic review and synthesis: is it meaningful, and if so, how should it be performed? Res Synth Methods. 2015;6:149–54.

    Article  PubMed  Google Scholar 

  • Carroll C, Booth A, Lloyd-Jones M. Should we exclude inadequately reported studies from qualitative systematic reviews? An evaluation of sensitivity analyses in two case study reviews. Qual Health Res. 2012;22:1425–34.

    Article  PubMed  Google Scholar 

  • Dixon-Woods M. Using framework-based synthesis for conducting reviews of qualitative studies. BMC Med. 2011;9.

    Google Scholar 

  • Dixon-Woods M, Bonas S, Booth A, Jones D, Miller T, Sutton A, et al. How can systematic reviews incorporate qualitative research? A critical perspective. Qual Res. 2006a;6:27–44.

    Article  Google Scholar 

  • Dixon-Woods M, Cavers D, Agarwal S, Annandale E, Arthur A, Harvey J, et al. Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups. BMC Med Res Methodol. 2006b;6:35.

    Article  PubMed  PubMed Central  Google Scholar 

  • Finfgeld-Connett D. Generalizability and transferability of meta-synthesis research findings. J Adv Nurs. 2010;66:246–54.

    Article  PubMed  Google Scholar 

  • Finfgeld-Connett D, Johnson ED. Literature search strategies for conducting knowledge-building and theory-generating qualitative systematic reviews. J Adv Nurs. 2012;69:194–204.

    Article  PubMed  PubMed Central  Google Scholar 

  • Flemming K, Briggs M. Electronic searching to locate qualitative research: evaluation of three strategies. J Adv Nurs. 2007;57:95–100.

    Article  PubMed  Google Scholar 

  • France EF, Ring N, Thomas R, Noyes J, Maxwell M, Jepson R. A methodological systematic review of what’s wrong with meta-ethnography reporting. BMC Med Res Methodol. 2014;14:119.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gagnon M-P, Lepage-Savary D, Gagnon J, St-Pierre M, Simard C, Rhainds M, et al. Introducing patient perspective in health technology assessment at the local level. BMC Health Serv Res. 2009;9:54.

    Article  PubMed  PubMed Central  Google Scholar 

  • Garside R. A comparison of methods for the systematic review of qualitative research : two examples using meta-ethnography and meta-study. Dissertation, Universities of Exeter and Plymouth. 2008.

    Google Scholar 

  • Gorecki CA, Brown JM, Briggs M, Nixon J. Evaluation of five search strategies in retrieving qualitative patient-reported electronic data on the impact of pressure ulcers on quality of life. J Adv Nurs. 2010;66:645–52.

    Article  PubMed  Google Scholar 

  • Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ. 2005;331:1064–5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Hansen HP, Draborg E, Kristensen FB. Exploring qualitative research synthesis: the role of patients’ perspectives in health policy design and decision making. Patient. 2011;4:143–52.

    Article  PubMed  Google Scholar 

  • Harris J, Croot L, Thompson J, Springett J. How stakeholder participation can contribute to systematic reviews of complex interventions. J Epidemiol Community Health. 2015;70:207–14.

    Article  PubMed  PubMed Central  Google Scholar 

  • Healthtalk. http://www.healthtalk.org/ (2016). Accessed 23 Nov 2016.

  • Heyvaert M, Hannes K, Onghena P. Using mixed methods research synthesis for literature reviews. Mixed methods research series, vol. 4. London: Sage; 2016.

    Google Scholar 

  • InterTASC Information Specialists’ Sub-Group (ISSG) Filters to Identify Studies of Patient Views and Patient Experiences [online]. [Online]. Sites.google.com: InterTASC Information Specialists’ Sub-Group (ISSG) Information Specialists’ Sub-Group (ISSG). 2016b. Available: https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/filters-to-identify-studies-of-public-views-and-patient-issues. Accessed 8 Apr 2016.

  • InterTASC Information Specialists’ Sub-Group (ISSG). Filters to Identify Quality of Life Studies [online]. [Online]. Sites.google.com: InterTASC Information Specialists’ Sub-Group (ISSG) Information Specialists' Sub-Group (ISSG). 2016a. Available: https://sites.google.com/a/york.ac.uk/issg-search-filters-resource/filters-to-identify-quality-of-life-studies [Accessed 8 Apr. 2016 2016].

  • Lewin S, Glenton C, Munthe-Kaas H, Carlsen B, Colvin CJ, Gülmezoglu M, et al. Using qualitative evidence in decision making for health and social interventions: an approach to assess confidence in findings from qualitative evidence syntheses (GRADE-CERQual). PLoS Med. 2015;12:e1001895.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lorenc T, Pearson M, Jamal F, Cooper C, Garside R. The role of systematic reviews of qualitative evidence in evaluating interventions: a case study. Res Synth Methods. 2012;3:1–10.

    Article  PubMed  Google Scholar 

  • McKibbon KA, Wilczynski NL, Haynes RB. Developing optimal search strategies for retrieving qualitative studies in PsycINFO. Eval Health Prof. 2006;29:440–54.

    Article  PubMed  Google Scholar 

  • Millar R, Powell M, Dixon A. What was the programme theory of New Labour’s Health System Reforms? J Health Serv Res Policy. 2012;17:Suppl 1:7–15.

    Google Scholar 

  • Morrell CJ, Sutcliffe P, Booth A, Stevens J, Scope A, Stevenson M, et al. A systematic review, evidence synthesis and meta-analysis of quantitative and qualitative studies evaluating the clinical effectiveness, the cost-effectiveness, safety and acceptability of interventions to prevent postnatal depression. Health Technol Assess. 2016;20(37):1–414.

    Article  PubMed  PubMed Central  Google Scholar 

  • Newton B, Rothlingova Z, Gutteridge R, Lemarchand K, Raphael J. No room for reflexivity? Critical reflections following a systematic review of qualitative research. J Health Psychol. 2012;17:866–85.

    Article  PubMed  Google Scholar 

  • Oliver K, Rees R, Brady LM, Kavanagh J, Oliver S, Thomas J. Broadening public participation in systematic reviews: a case example involving young people in two configurative reviews. Res Synth Methods, 2015;6:206–17.

    Google Scholar 

  • Oliver SR, Rees RW, Clarke-Jones L, Milne R, Oakley AR, Gabbay J, et al. A multidimensional conceptual framework for analysing public involvement in health services research. Health Expect. 2008;11:72–84.

    Article  PubMed  PubMed Central  Google Scholar 

  • Papaioannou D, Sutton A, Carroll C, Booth A, Wong R. Literature searching for social science systematic reviews. Health Inf Libr J. 2010;27:114–22.

    Article  Google Scholar 

  • Paterson BL, Thorne S, Dewis M. Adapting to and managing diabetes. Image J Nurs Sch. 1998;30:57–62.

    Article  CAS  PubMed  Google Scholar 

  • Pluye P, Hong QN. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews. Annu Rev Public Health. 2014;35:29–45.

    Article  PubMed  Google Scholar 

  • Popay J, Roberts H, Sowden A, Petticrew M, Arai L. Guidance on the conduct of narrative synthesis in systematic reviews. A product from the ESRC methods programme. Lancaster: Institute for Health Research; 2006.

    Google Scholar 

  • Riesenberg LA, Justice EM. Conducting a successful systematic review of the literature, part 1. Nursing. 2014;44:13–7.

    Article  PubMed  Google Scholar 

  • Ring N, Jepson R, Ritchie K. Methods of synthesizing qualitative research studies for health technology assessment. Int J Technol Assess Health Care. 2011a;27:384–90.

    Article  PubMed  Google Scholar 

  • Ring N, Ritchie K, Mandava L, Jepson R. A guide to synthesising qualitative research for researchers undertaking health technology assessments and systematic reviews. NHS Quality Improvement Scotland; 2011b. Available: http://www.nhshealthquality.org/nhsqis/8837.html. Accessed 8 Apr 2016.

  • Roberts KA, Dixon-Woods M, Fitzpatrick R, Abrams KR, Jones DR. Factors affecting uptake of childhood immunisation: a Bayesian synthesis of qualitative and quantitative evidence. Lancet. 2002;360:1596–9.

    Article  PubMed  Google Scholar 

  • Robertson C, Archibald D, Avenell A, Douglas F, Hoddinott P, Van Teijlingen E, et al. Systematic reviews of, and integrated report, on the quantitative, qualitative and economic evidence base for the management of obesity in men. Health Technol Assess. 2014;18(35):1–424.

    Article  Google Scholar 

  • Rycroft-Malone J, McCormack B, Hutchinson AM, Decorby K, Bucknall TK, Kent B, et al. Realist synthesis: illustrating the method for implementation research. Implement Sci. 2012;7:33.

    Article  PubMed  PubMed Central  Google Scholar 

  • Saul JE, Willis CD, Bitz J, Best A. A time-responsive tool for informing policy making: rapid realist review. Implement Sci. 2013;8:103.

    Article  PubMed  PubMed Central  Google Scholar 

  • Stansfield C, Kavanagh J, Rees R, Gomersall A, Thomas J. The selection of search sources influences the findings of a systematic review of people’s views: a case study in public health. BMC Med Res Methodol. 2012;12.

    Google Scholar 

  • Stern C, Jordan Z, McArthur A. Developing the review question and inclusion criteria. Am J Nurs. 2014;114:53–6.

    Article  PubMed  Google Scholar 

  • Subirana M, Sola I, Garcia JM, Gich I, Urrutia G. A nursing qualitative systematic review required MEDLINE and CINAHL for study identification. J Clin Epidemiol. 2005;58:20–5.

    Article  PubMed  Google Scholar 

  • Suri H. Purposeful sampling in qualitative research synthesis. Qual Res J. 2011;11:63–75.

    Google Scholar 

  • Thomas J, O’Mara-Eves A, Brunton G. Using qualitative comparative analysis (QCA) in systematic reviews of complex interventions: a worked example. Syst Rev. 2014;3:67.

    Article  PubMed  PubMed Central  Google Scholar 

  • Tobiano G, Marshall A, Bucknall T, Chaboyer W. Patient participation in nursing care on medical wards: an integrative review. Int J Nurs Stud. 2015;52:1107–20.

    Article  PubMed  Google Scholar 

  • Toye F, Seers K, Allcock N, Briggs M, Carr E, Andrews J, et al. Patients’ experiences of chronic non-malignant musculoskeletal pain: a qualitative systematic review. Br J Gen Pract. 2013;63:e829–41.

    Article  PubMed  PubMed Central  Google Scholar 

  • Walters LA, Wilczynski NL, Haynes RB. Developing optimal search strategies for retrieving clinically relevant qualitative studies in EMBASE. Qual Health Res. 2006;16:162–8.

    Article  PubMed  Google Scholar 

  • Warr DJ. Stories in the flesh and voices in the head: reflections on the context and impact of research with disadvantaged populations. Qual Health Res. 2004;14:578–87.

    Article  PubMed  Google Scholar 

  • Whitaker R, Hendry M, Aslam R, Booth A, Carter B, Charles JM, et al. Intervention now to eliminate repeat unintended pregnancy in teenagers (INTERUPT): a systematic review of intervention effectiveness and cost-effectiveness, and qualitative and realist synthesis of implementation factors and user engagement. Health Technol Assess. 2016;20:1–214.

    Article  PubMed  PubMed Central  Google Scholar 

  • Wilczynski NL, Marks S, Haynes RB. Search strategies for identifying qualitative studies in CINAHL. Qual Health Res. 2007;17:705–10.

    Article  PubMed  Google Scholar 

  • Wong SSL, Wilczynski NL, Haynes RB. Developing optimal search strategies for detecting clinically relevant qualitative studies in MEDLINE. MedInfo 2004: Proceedings of the 11th World Congress on Medical Informatics, Pt 1 and 2. 2004;107: 311–14.

    Google Scholar 

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Booth, A. (2017). Qualitative Evidence Synthesis. In: Facey, K., Ploug Hansen, H., Single, A. (eds) Patient Involvement in Health Technology Assessment. Adis, Singapore. https://doi.org/10.1007/978-981-10-4068-9_15

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  • DOI: https://doi.org/10.1007/978-981-10-4068-9_15

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