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      A methodological systematic review of meta-ethnography conduct to articulate the complex analytical phases

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          Abstract

          Background

          Decision making in health and social care requires robust syntheses of both quantitative and qualitative evidence. Meta-ethnography is a seven-phase methodology for synthesising qualitative studies. Developed in 1988 by sociologists in education Noblit and Hare, meta-ethnography has evolved since its inception; it is now widely used in healthcare research and is gaining popularity in education research. The aim of this article is to provide up-to-date, in-depth guidance on conducting the complex analytic synthesis phases 4 to 6 of meta-ethnography through analysis of the latest methodological evidence.

          Methods

          We report findings from a methodological systematic review conducted from 2015 to 2016. Fourteen databases and five other online resources were searched. Expansive searches were also conducted resulting in inclusion of 57 publications on meta-ethnography conduct and reporting from a range of academic disciplines published from 1988 to 2016.

          Results

          Current guidance on applying meta-ethnography originates from a small group of researchers using the methodology in a health context. We identified that researchers have operationalised the analysis and synthesis methods of meta-ethnography – determining how studies are related (phase 4), translating studies into one another (phase 5), synthesising translations (phase 6) and line of argument synthesis - to suit their own syntheses resulting in variation in methods and their application. Empirical research is required to compare the impact of different methods of translation and synthesis. Some methods are potentially better at preserving links with the context and meaning of primary studies, a key principle of meta-ethnography. A meta-ethnography can and should include reciprocal and refutational translation and line of argument synthesis, rather than only one of these, to maximise the impact of its outputs.

          Conclusion

          The current work is the first to articulate and differentiate the methodological variations and their application for different purposes and represents a significant advance in the understanding of the methodological application of meta-ethnography.

          Electronic supplementary material

          The online version of this article (10.1186/s12874-019-0670-7) contains supplementary material, which is available to authorized users.

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          Most cited references53

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          The Discovery of Grounded Theory

          <p>Most writing on sociological method has been concerned with how accurate facts can be obtained and how theory can thereby be more rigorously tested. In The Discovery of Grounded Theory, Barney Glaser and Anselm Strauss address the equally Important enterprise of how the discovery of theory from data--systematically obtained and analyzed in social research--can be furthered. The discovery of theory from data--grounded theory--is a major task confronting sociology, for such a theory fits empirical situations, and is understandable to sociologists and laymen alike. Most important, it provides relevant predictions, explanations, interpretations, and applications.</p><p>In Part I of the book, Generation Theory by Comparative Analysis, the authors present a strategy whereby sociologists can facilitate the discovery of grounded theory, both substantive and formal. This strategy involves the systematic choice and study of several comparison groups. In Part II, The Flexible Use of Data, the generation of theory from qualitative, especially documentary, and quantitative data Is considered. In Part III, Implications of Grounded Theory, Glaser and Strauss examine the credibility of grounded theory.</p><p>The Discovery of Grounded Theory is directed toward improving social scientists' capacity for generating theory that will be relevant to their research. While aimed primarily at sociologists, it will be useful to anyone Interested In studying social phenomena--political, educational, economic, industrial-- especially If their studies are based on qualitative data.</p></p>
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            Applying GRADE-CERQual to qualitative evidence synthesis findings: introduction to the series

            The GRADE-CERQual (‘Confidence in the Evidence from Reviews of Qualitative research’) approach provides guidance for assessing how much confidence to place in findings from systematic reviews of qualitative research (or qualitative evidence syntheses). The approach has been developed to support the use of findings from qualitative evidence syntheses in decision-making, including guideline development and policy formulation. Confidence in the evidence from qualitative evidence syntheses is an assessment of the extent to which a review finding is a reasonable representation of the phenomenon of interest. CERQual provides a systematic and transparent framework for assessing confidence in individual review findings, based on consideration of four components: (1) methodological limitations, (2) coherence, (3) adequacy of data, and (4) relevance. A fifth component, dissemination (or publication) bias, may also be important and is being explored. As with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach for effectiveness evidence, CERQual suggests summarising evidence in succinct, transparent, and informative Summary of Qualitative Findings tables. These tables are designed to communicate the review findings and the CERQual assessment of confidence in each finding. This article is the first of a seven-part series providing guidance on how to apply the CERQual approach. In this paper, we describe the rationale and conceptual basis for CERQual, the aims of the approach, how the approach was developed, and its main components. We also outline the purpose and structure of this series and discuss the growing role for qualitative evidence in decision-making. Papers 3, 4, 5, 6, and 7 in this series discuss each CERQual component, including the rationale for including the component in the approach, how the component is conceptualised, and how it should be assessed. Paper 2 discusses how to make an overall assessment of confidence in a review finding and how to create a Summary of Qualitative Findings table. The series is intended primarily for those undertaking qualitative evidence syntheses or using their findings in decision-making processes but is also relevant to guideline development agencies, primary qualitative researchers, and implementation scientists and practitioners. Electronic supplementary material The online version of this article (10.1186/s13012-017-0688-3) contains supplementary material, which is available to authorized users.
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              Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care

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                Author and article information

                Contributors
                emma.france@stir.ac.uk
                Isabelle.uny@stir.ac.uk
                N.Ring@napier.ac.uk
                TurleyRL@cardiff.ac.uk
                Margaret.maxwell@stir.ac.uk
                Edward.duncan@stir.ac.uk
                ruth.jepson@ed.ac.uk
                Rachel.Roberts@rpharms.com
                jane.noyes@bangor.ac.uk
                Journal
                BMC Med Res Methodol
                BMC Med Res Methodol
                BMC Medical Research Methodology
                BioMed Central (London )
                1471-2288
                18 February 2019
                18 February 2019
                2019
                : 19
                : 35
                Affiliations
                [1 ]ISNI 0000 0001 2248 4331, GRID grid.11918.30, NMAHP Research Unit, , University of Stirling, ; Unit 13 Scion House, Stirling University Innovation Park, Stirling, FK9 4NF UK
                [2 ]ISNI 000000012348339X, GRID grid.20409.3f, School of Health and Social Care, , Edinburgh Napier University, ; Sighthill Campus, Sighthill Court, Edinburgh, EH11 4BN UK
                [3 ]ISNI 0000 0001 0807 5670, GRID grid.5600.3, DECIPHEr, School of Social Sciences, , Cardiff University, ; Glamorgan Building, King Edward VII, Cardiff, CF10 3WT UK
                [4 ]ISNI 0000 0004 1936 7988, GRID grid.4305.2, Scottish Collaboration for Public Health Research and Policy, , University of Edinburgh, ; 20 West Richmond Street, Edinburgh, EH8 9DX UK
                [5 ]ISNI 0000000118820937, GRID grid.7362.0, School of Health Sciences, , Bangor University, ; Bangor, Gwynedd LL57 2EF UK
                Author information
                http://orcid.org/0000-0003-0876-7030
                Article
                670
                10.1186/s12874-019-0670-7
                6380066
                30777031
                fd9e23ca-6de2-4604-9e76-d2e0bc34d743
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 September 2018
                : 28 January 2019
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100002001, Health Services and Delivery Research Programme;
                Award ID: 13/114/60
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Medicine
                meta-ethnography,systematic review,qualitative evidence synthesis,meta-synthesis,qualitative research,research design,methodology

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