Study Design
A Rapid Response Summary with Critical Appraisal of the qualitative literature will be conducted describing the perspectives of people who have undergone testing for acute PE, or testing with the diagnostic imaging technologies included in this review for other pulmonary, hematological, or cardiac conditions. The perspectives of family members, and other non-clinical caregivers, will be considered.
The final report will include a summary of the evidence, study characteristics, and findings, as well as a brief statement on implications for decision-making or policy-making.
Selection Criteria and Methods
One reviewer will screen citations identified through the literature search. In the first level of screening, titles and abstracts will be reviewed and the full text of potentially relevant articles will be retrieved and assessed for inclusion by the same reviewer. The final selection of full-text articles will be based on the inclusion criteria in . The study selection process will be presented in a PRISMA flow chart.48
Selection Criteria for Patient Preference and Experience Questions.
Exclusion Criteria
To be eligible, studies must explore or assess the perspectives of patients and caregivers directly and not indirectly; for example, through another person. Studies that assess only clinician perspectives will be excluded. The following types of publications will also be excluded: theses and dissertations, data presented in abstract form only, book chapters, editorials, and letters to the editor. Studies will be excluded if they are not published in English.
Data Extraction
Data collection will involve extracting data regarding study characteristics and study results from primary reports, as relevant to the research question. From each eligible article, descriptive data will be extracted by one reviewer into a standardized electronic form. Descriptive data will include such items as first author, article title, study objectives, participant characteristics, and study design. Result statements from the eligible articles relevant to the research question will be captured for analysis using NVivo qualitative data analysis software (QSR International Pty Ltd. version 11, 2015). Result statements are typically presented within the “results” section of a report and are characterized as data-driven and integrated findings based on participant experiences. Before being coded, each result statement will be assessed to ensure it is differentiated from raw data, methods, external data, and researchers’ conclusions and implications. The latter will not be coded. Only results presented within the main report will be coded. Data from figures will not be used unless data points are explicitly labelled.
Quality Assessment
The included qualitative studies will be critically appraised by one reviewer using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist69 and the JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses as a guide.70 A summary of the strengths and limitations of each included study will be reported.
Summary of Evidence and Data Synthesis
Description of Study Characteristics
A narrative summary of study characteristics, including the total number of studies by PICOS elements, will be provided, alongside descriptive information including countries and years of publication and sample size. A table will be developed to accompany the narrative summary and to ensure consistency of presented information across all studies and facilitate study comparisons by the reader.
Summary of Critical Appraisal
A narrative summary of the results of the critical appraisal will be presented, including an overall impression of the quality of included studies. Tables will accompany the narrative summary to ensure consistency of presented information across all studies and to facilitate study comparisons by the reader. Tables will present the strengths and limitations of each study, following the criteria used to conduct the critical appraisal.
Content Analysis
A content analysis will be conducted by coding relevant result statements within the included articles line by line, and subsequently organizing the data into common categories.71 The analysis will be conducted using NVivo qualitative data analysis software; QSR International Pty Ltd. Version 11, 2015.72 The content analysis will be conducted by a single reviewer, who will maintain extensive field notes and a study journal to memo emerging insights, and how the analysis evolves. Regular meetings with the study team will serve a peer-debriefing and peer-review function, to challenge emerging ideas and help ensure the analysis stays close to the data.
Coding will begin with an a priori “start list” of codes developed based on the research questions; for example, perceived benefits and harms, challenges, and psychological and physical distress. As coding progresses, other codes not on the start list will emerge inductively to capture unexpected meaning and content grounded in the results themselves. When new codes emerge, all data will be recoded to search for further instances of the meaning captured by that code.
Once all data have been coded, the codes will be organized into related areas to construct descriptive categories that represent and encompass codes with similar meanings. In this process, the reviewer will look for similarities and differences between codes and group together similar codes. Once categories have been identified, a draft definition of each code and category will be written by the reviewer. Descriptions of the data within each code and category will also be prepared, and these will remain close to the data with minimal interpretation. Where apparent, differences between various populations — for example, men and women or older and younger people — will be noted in these descriptions. Exemplar quotations will also be included, if appropriate.
