Content Comparison

Methodological development for quantitative systematic reviews of effects has broad scientific consensus, however the same cannot be said across the field qualitative synthesis. In qualitative synthesis, the normative features ascribed to systematic reviews of quantitative data have been challenged, adopted, rejected, or transposed to different extents into analogous concepts and methods more attune to the nuances of the critical and interpretive research paradigmsIn the field of evidence-based healthcare, qualitative systematic reviews are an important tool for understanding the nuanced and multifaceted aspects of patient and public experiences, preferences, and the social, cultural and psychological factors that influence health outcomes and decision-making.

The unique strength of qualitative systematic reviews lies in synthesising the findings of primary qualitative studies to uncover insights and to address critical questions that quantitative research alone cannot fully address. By exploring the preferences, values, understandings, opinions, attitudes and experiences of individuals and social groups (e.g. patients, the public, healthcare professionals, carers), qualitative systematic reviews can illuminate meanings and social processes, identify common themes and challenges, and provide a deeper understanding of the complex and often multifaceted factors that influence health and healthcare. These insights can lead to the development of appropriate interventions, address care gaps, support practice change and enhance quality and equity of healthcare by tackling health disparities and developing innovative intervention strategies. These, in turn, contribute to a more person-centred, equitable and effective healthcare system.

The purpose of this chapter is to provide the rationale, methodology and methods for meta aggregation as an approach to qualitative synthesis. Its developmental history is grounded in philosophic perspectives with the needs and expectations of evidence to inform health care decision-making. Meta aggregation is a method that mirrors the accepted conventions for systematic review whilst holding to the traditions and requirements of qualitative research (it aggregates findings in to a combined whole that is more than the sum of the individual findings in a way that is analogous with meta analysis). situate qualitative systematic reviews within the broader field of evidence synthesis and evidence-based healthcare, and to provide detailed guidance for reviewers undertaking JBI’s endorsed approach to conducting qualitative evidence synthesis. We acknowledge that there are alternative approaches to undertaking qualitative evidence synthesis (Booth et al. 2016, 2018; Flemming & Noyes 2021; Hannes & Lockwood 2011a; Noblit & Hare 1988; Thomas & Harden 2008). This guidance specifically focuses on JBI’s approach, commonly referred to as meta-aggregation (Lockwood, Munn & Porritt 2015).

This chapter outlines the rationale for undertaking meta-aggregation and describes the methodology and methods for conducting a qualitative systematic review using a meta-aggregative approach. Key operational assumptions and definitions of core terms are included in this section.

What is new in this update?

• Existing sections revised and improved to provide more detailed guidance, enhanced explanations and more examples

• New sections:

o   Theoretical underpinnings (section 3.3.1)

o   Equity qualitative evidence synthesis (section 3.3.2)

o   Reflexivity (section 3.3.3)

o   Review team (section 3.3.4)

o   Selecting a title for the systematic review (section 3.3.6)

o   Selecting qualitative studies (section 3.3.10)

o   Presenting the synthesis (section 3.3.14)

o   Assessment of confidence in qualitative synthesised findings (section 3.3.15)

o   Developing recommendations for practice/research (section 3.3.16)

o   Tools, resources and software in the review process (section 3.4)