This section of the protocol should include details of how the extracted data will be synthesized. The aim of meta-aggregation is to: firstly, assemble conclusions; secondly, categorize these conclusions into categories based on similarity in meaning; and thirdly, to aggregate these to generate a set of statements that adequately represent that aggregation. These statements are referred to as synthesized findings and they can be used as a basis for evidence-based practice. In order to facilitate this process, as with ensuring a common understanding of the appraisal criteria and how they will be applied, reviewers need to discuss synthesis and work to common understandings on the assignment of categories, and assignment to synthesized findings.
JBI SUMARI describes a particular approach to the synthesis of textual papers. As with meta-aggregation in the qualitative module, synthesis is a three-step analytical process undertaken within the text and opinion module. Textual papers will, where possible, be pooled using JBI SUMARI. This involves the aggregation or synthesis of conclusions to generate a set of statements that represent that aggregation, through assembling and categorizing these conclusions on the basis of similarity in meaning. These categories are then subjected to a meta-synthesis in order to produce a single comprehensive set of synthesized findings that can be used as a basis for evidence-based practice. Where textual pooling is not possible the conclusions are presented in narrative form.
The aim of synthesis is for the reviewer to establish synthesized findings by bringing together key conclusions drawn from all of the included papers. The units of extraction in this process are specific conclusions stated by the author/speaker and the text that demonstrate the argument or basis of the conclusion. Conclusions are principal opinion statements embedded in the paper and are identified by the reviewer after examining the text in the paper. It is for this reason that reviewers are required to read and re-read the paper closely to identify the conclusions to be entered into JBI SUMARI. Conclusions should be extracted as verbatim statements from the author.
Assessing Confidence
The final synthesized findings will be graded according to the ConQual approach for establishing confidence in the output of textual synthesis and presented in a Summary of Findings table. (Munn et al, 2014) The Summary of Findings table includes the major elements of the review and details how the ConQual score is developed. Included in the table is the title, population, phenomena of interest and context for the specific review. Each synthesized finding from the review is then presented along with the type of research informing it, a score for dependability, credibility, and the overall ConQual score.