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Cunningham M, France EF, Ring N, et al. Developing a reporting guideline to improve meta-ethnography in health research: the eMERGe mixed-methods study. Southampton (UK): NIHR Journals Library; 2019 Feb. (Health Services and Delivery Research, No. 7.4.)
Developing a reporting guideline to improve meta-ethnography in health research: the eMERGe mixed-methods study.
Show detailsTABLE 8
Meta-ethnography phase 0 | Standard number | Reporting criteria | Meta-ethnography publications, n (%) | |
---|---|---|---|---|
Number of standards applicable to any meta-ethnography: 7 Number of standards applicable only to some meta-ethnographies: 0 | Standard met in full or in part | Standard not met or not reported | ||
Phase 0: choosing meta-ethnography | 1 | Studies report why meta-ethnography was considered most appropriate QES methodology | 14 (73.6) | 5 (26.3) |
2 | Reviewers state their initial intention was to produce a new theory, interpretation or model (even if this was not ultimately possible) | 12 (63.1) | 7 (36.8) | |
3 | Reviewers state the type of social explanation(s) review findings are expected to produce | 17 (89.4) | 2 (10.5) | |
4 | Reviewers state type of social explanation(s) review is expected to produce in line with Turner’s theory45 | 2 (10.5) | 17 (89.4) | |
5 | The qualitative expertise of reviewers is stated | 0 (0) | 19 (100) | |
6 | Review context is stated (e.g. any funding sources, time scales for meta-ethnography), findings to inform guideline development, Health Technology Assessment or promote evidence implementation | 15 (78.9) | 4 (21.0) | |
7 | Reviewer(s) perspectives contributing to this interpretive process is/are stated [e.g. epistemological position(s), positions held, academic disciplines, organisation(s) or health bodies represented, cultural diversity] | 7 (36.8) | 12 (63.1) |
QES, qualitative evidence synthesis.
TABLE 9
Meta-ethnography phase 1 | Standard number | Reporting criteria | Meta-ethnography publications, n (%) | |
---|---|---|---|---|
Number of standards applicable to any meta-ethnography: 5 Number of standards applicable only to some meta-ethnographies: 4 (shaded green) | Standard met in full or in part | Standard not met or not reported | ||
Phase 1: getting started with meta-ethnography | 8 | Information (e.g. in a literature review) on the availability of qualitative data that potentially could be synthesised is provided | 10 (52.6) | 9 (47.3) |
9 | A statement on the research/knowledge gap to be filled by meta-ethnography (or an updated meta-ethnography) is given | 18 (94.7) | 1 (5.2) | |
10 | Explicitly stated review aim(s) | 19 (100) | 0 (0) | |
11 | Explicitly stated review questions or objectives | 6 (31.5) | 13 (68.4) | |
12 | Review aim(s) and/or questions congruent with meta-ethnography (e.g. reviewers intend to produce new interpretation, model or theory) | 12 (63.1) | 7 (36.8) | |
13 | If the meta-ethnography approach was reported as adapted/modified: Adaptations/modifications should be clearly described | 1 | – | |
14 | If the meta-ethnography approach was reported as adapted/modified, a rationale for any adaptations or modifications is given | 1 | – | |
15 | If the meta-ethnography approach was reported as adapted/modified, reviewers state whether or not they considered using another QES approach rather than adapting/modifying meta-ethnography | 0 | – | |
16 | If reviewers reported changing/refining their initial aims and/or questions following literature review, details of changes or refinements to the initial aims and/or research questions are given | 1 | – |
QES, qualitative evidence synthesis.
TABLE 10
Meta-ethnography phase 2 | Standard number | Reporting criteria | Meta-ethnography publications, n (%) | |
---|---|---|---|---|
Number of standards applicable to any meta-ethnography: 17 Number of standards applicable only to some meta-ethnographies: 12 (shaded green) | Standard met in full or in part | Standard not met or not reported | ||
Phase 2: deciding what is relevant | 17 | A statement(s) regarding the choice of overall search strategy is given (e.g. how this was informed by review purpose and intended audience) | 10 (52.6) | 9 (47.3) |
18 | Details on the electronic database(s) search strategies used (e.g. thesaurus, free text and broad-based terms) | 13 (68.4) | 6 (31.5) | |
19 | Details on the electronic databases searched | 19 (100) | 0 (0) | |
20 | Details on the searching approach(es) used (e.g. comprehensive, purposive or combined) | 19 (100) | 0 (0) | |
21 | Details on the alternative searching methods (e.g. if e-databases were not used) | 5 (26.3) | 14 (73.6) | |
22 | Details of all the data search processes and procedures including number of reviewer(s) involved in literature searching | 6 (31.5) | 13 (68.4) | |
23 | Details of all the data search processes and procedures including which reviewer(s) were involved in literature searching | 5 (26.3) | 14 (73.6) | |
24 | Details of all the data search processes and procedures including whether or not reviewers worked independently and then collaboratively to review searching decisions | 6 (31.5) | 13 (68.4) | |
25 | Details of all the data search processes and procedures including if complementary searching conducted (e.g. hand and/or internet searches and/or original authors were contacted) | 17 (89.4) | 2 (10.5) | |
26 | Details of all the data search processes and procedures including years data search covered | 16 (84.2) | 3 (15.7) | |
27 | Details of all the data search processes and procedures including rationale for years data search covered | 6 (31.5) | 13 (68.4) | |
28 | Details of all the data search processes and procedures including time period over which searches were conducted (e.g. weeks/months that reviewers took to search for studies) | 4 (21.0) | 15 (78.9) | |
29 | Details of all the data search processes and procedures including whether or not potential studies were screened by titles and abstracts prior to reading full texts | 15 (78.9) | 4 (21.0) | |
30 | Details of all the data search processes and procedures including rationale for stopping searching is provided | 0 (0) | 19 (100) | |
31 | Detailed study inclusion/exclusion criteria, for example whether or not:
| 19 (100) | 0 (0) | |
32 | Explicit information on the number of qualitative studies found for inclusion in meta-ethnography | 18 (94.7) | 1 (5.2) | |
33 | Explicit information on the number of studies actually synthesised | 19 (100) | 0 (0) | |
34 | If initial searches were updated later, details are provided | 0 | – | |
35 | Appropriate literature searching reporting formats (e.g. PRISMA, STARLITE89) if the meta-ethnography used comprehensive literature searches in the style of quantitative systematic reviews | 11 | – | |
36 | If reviewers used a sample rather than all studies meeting inclusion/exclusion criteria: details of the type of sample (e.g. exhaustive or purposive) are provided | 3 | – | |
37 | If reviewers used a sample rather than all studies meeting inclusion/exclusion criteria, a rationale for the type of sample used is given (e.g. only heterogeneous studies were included) | 3 | – | |
38 | If the review limited included studies to a maximum (e.g. 50), the maximum number is clearly stated | 0 | – | |
39 | If the review limited included studies to a maximum (e.g. 50), the rationale for this maximum number is stated | 0 | – | |
40 | If the review limited included studies to a maximum (e.g. 50), studies excluded because maximum number was exceeded are identified | 0 | – | |
41 | If included studies were quality appraised, the type of quality processes/tools/methods used are specified | 15 | – | |
42 | If included studies were quality appraised, a rationale is given for the choice of quality assessment processes | 8 | – | |
43 | If included studies were quality appraised, it is clear which reviewer(s) conducted the quality appraisal | 6 | – | |
44 | If included studies were quality appraised, the outcome of any quality appraisal processes are provided | 13 | – | |
45 | If included studies were quality appraised, any studies excluded following quality appraisal are clearly identified | 5 | – |
TABLE 11
Meta-ethnography phase 3 | Standard number | Reporting criteria | Meta-ethnography publications, n (%) | |
---|---|---|---|---|
Number of standards applicable to any meta-ethnography: 13 Number of standards applicable only to some meta-ethnographies: 5 (shaded green) | Standard met in full or in part | Standard not met or not reported | ||
Phase 3: reading included studies | 46 | How many reviewers read full papers/reports is stated | 10 (52.6) | 9 (47.3) |
47 | Whether or not papers were read in full is stated | 14 (73.6) | 5 (26.3) | |
48 | What order papers were read in (e.g. starting point for reading was an index paper or a particular year) | 3 (15.7) | 16 (84.2) | |
49 | Why that reading order was chosen is specified | 0 (0) | 19 (100) | |
50 | Data extraction processes: which reviewer(s) extracted data for participant and context details is stated | 5 (26.3) | 14 (73.6) | |
51 | Which reviewer(s) extracted data for first- and second-order constructs is stated | 7 (36.8) | 12 (63.1) | |
52 | Where data were extracted from is stated (e.g. if used findings in original studies or findings and discussion sections, etc.) | 8 (42.1) | 11 (57.8) | |
53 | Whether or not data were extracted independently by reviewers is stated | 9 (47.3) | 10 (52.6) | |
54 | Whether or not extracted data were checked for accuracy is stated | 6 (31.5) | 13 (68.4) | |
55 | What order data were extracted is stated in (e.g. chronological or started with index paper) | 4 (21.0) | 15 (78.9) | |
56 | Reason why data extracted in that order is stated | 0 (0) | 19 (100) | |
57 | Where data were extracted to is stated (e.g. into Microsoft Word documents, diagrams or qualitative data analysis software) | 11 (57.8) | 8 (42.1) | |
58 | The context (characteristics or summaries) of included studies is provided for readers in narrative and/or tabular form and includes key information [e.g. original study aim(s) re: study country/countries, health setting, any funding; data collection methods (e.g. focus groups); details of participants (e.g. number, age, gender, socioeconomic status); any significant contextual developments impacting on the included papers (e.g. launch of a new health strategy or an international public health outbreak)] | 18 (94.7) | 1 (5.2) | |
59 | Studies excluded on detailed reading because their contexts are clearly identified | 2 | – | |
60 | Studies excluded on detailed reading because their contexts have an explanation provided for their exclusion (e.g. studies not homogeneous) | 3 | – | |
61 | Studies excluded on full-text reading because of the lack of rich conceptually deep data are clearly identified | 2 | – | |
62 | Studies excluded on full-text reading because of the lack of rich conceptually deep data have a rationale provided for these exclusions (e.g. survey data only) | 3 | – | |
63 | Studies excluded on full text reading because of the lack of rich conceptually deep data: reviewers state whether or not authors of these studies were contacted for additional data (e.g. full study reports) | 1 | – |
TABLE 12
Meta-ethnography phase 4 | Standard number | Reporting criteria | Meta-ethnography publications, n (%) | |
---|---|---|---|---|
Number of standards applicable to any meta-ethnography: 6 Number of standards applicable only to some meta-ethnographies: 0 | Standard met in full or in part | Standard not met or not reported | ||
Phase 4: determining how studies are related | 64 | Details on how multiple perspectives were introduced into the translation and synthesis processes (e.g. if there was a single reviewer, was their interpretation presented to a wider group?) | 7 (36.8) | 12 (63.1) |
65 | How reviewers decided how studies were related: the basis on which they determined how studies were related is given (e.g. by theoretical approach and/or in metaphors, aims, focus, context) | 15 (78.9) | 4 (21.0) | |
66 | How reviewers decided how studies were related: whether or not studies were excluded during phase 4 and, if so, why (e.g. concepts or metaphors could not be deciphered or identified, theoretical approach or meta-ethnography focus) | 2 (10.5) | 17 (89.4) | |
67 | How reviewers decided how studies were related: report states how studies were compared/juxtaposed to decide how they relate | 14 (73.6) | 5 (26.3) | |
68 | How reviewers decided how studies were related: report states how studies relate to each other [e.g. are the studies commensurable (about roughly similar things)] | 15 (78.9) | 4 (21.0) | |
69 | How reviewers decided how studies were related: authors’ concepts/themes/metaphors (second-order constructs) (i.e. raw data) from original studies are clearly reported (e.g. in grids/tables, visual diagrams/maps) | 16 (84.2) | 3 (15.7) |
TABLE 13
Meta-ethnography phase 5 | Standard number | Reporting criteria | Meta-ethnography publications, n (%) | |
---|---|---|---|---|
Number of standards applicable to any meta-ethnography: 20 Number of standards applicable only to some meta-ethnographies: 0 | Standard met in full or in part | Standard not met or not reported | ||
Phase 5: translating studies | 70 | Translation processes (reciprocal and/or refutational): the different levels of interpretation (e.g. first-, second- and third-order constructs) within the translation/synthesis process are clearly differentiated for readers | 16 (84.2) | 3 (15.7) |
71 | Translation processes (reciprocal and/or refutational): reviewers report steps taken to preserve context and meaning of the relationships between concepts within and across studies | 8 (42.1) | 11 (57.8) | |
72 | Translation processes (reciprocal and/or refutational): the order in which studies were translated/synthesised | 8 (42.1) | 11 (57.8) | |
73 | Translation processes (reciprocal and/or refutational): the reason for the order in which studies were translated/synthesised is given | 4 (21.0) | 15 (78.9) | |
74 | Translation processes (reciprocal and/or refutational): state which kind(s) of translation or synthesis was done – reciprocal, refutational, and/or line of argument | 17 (89.4) | 2 (10.5) | |
75 | Translation processes (reciprocal and/or refutational): methods used to translate concepts from one study into another are specific and clearly stated | 12 (63.1) | 7 (36.8) | |
76 | Translation processes (reciprocal and/or refutational): reviewers involved in translation are identified | 5 (26.3) | 14 (76.3) | |
77 | Translation processes (reciprocal and/or refutational): studies included within translation are clearly identified | 19 (100) | 0 (0) | |
78 | Translation processes (reciprocal and/or refutational): a rationale is provided for studies excluded from translation | 2 (10.5) | 17 (89.4) | |
79 | Translation processes (reciprocal and/or refutational): the outcome of the translation is given – this could be in table, grid format or narrative | 18 (94.7) | 1 (5.2) | |
80 | Refutational analysis: reviewers state in which phase(s)/at which point refutational translation was considered | 11 (57.8) | 8 (42.1) | |
81 | Refutational analysis: reviewers state whether or not social and cultural factors were considered during refutational translation (e.g. whether or not age/gender of participants, settings/contexts may have contributed to disconfirming cases or whether or not reviewers considered how findings might be interpreted from different cultural or social perspectives) | 10 (52.6) | 9 (47.7) | |
82 | Refutational analysis: reviewers state if refutational translation was not possible and why | 2 (10.5) | 17 (89.4) | |
83 | LOA synthesis: reviewers state what they mean by LOA | 10 (52.6) | 9 (47.7) | |
84 | LOA synthesis: reviewers state which reviewer(s) were involved in the LOA | 7 (36.8) | 12 (63.1) | |
85 | LOA synthesis: reviewers state which studies were included in the LOA | 14 (73.6) | 5 (26.3) | |
86 | LOA synthesis: reviewers state explicitly and transparently steps taken in LOA | 9 (47.7) | 10 (52.6) | |
87 | LOA synthesis: reviewers state whether or not social and cultural factors were considered within the LOA | 6 (31.5) | 13 (68.4) | |
88 | LOA synthesis: reviewers state clearly their LOA findings; this could be in text or grid or table format | 15 (78.9) | 4 (21.0) | |
89 | LOA synthesis: reviewers state if LOA was not possible and why not | 0 (0) | 19 (100) |
TABLE 14
Meta-ethnography phase 6 | Standard number | Reporting criteria | Meta-ethnography publications, n (%) | |
---|---|---|---|---|
Number of standards applicable to any meta-ethnography: 3 Number of standards applicable only to some meta-ethnographies: 2 | Standard met in full or in part | Standard not met or not reported | ||
Phase 6: synthesising translations | 90 | Synthesising translations: reviewers state the methods used to develop overarching concepts (‘synthesised translations’) | 13 (68.4) | 6 (31.5) |
91 | Synthesising translations: reviewers state their new (third order) interpretation(s) in text and/or visually (e.g. as a model, theory or film) | 19 (100) | 0 (0) | |
92 | Synthesising translations: reviewers state which reviewer(s) were involved in this process | 8 (42.1) | 11 (57.8) | |
93 | Synthesising translations: reviewers state if development of a new theory, interpretation or model was not possible and why not | 1 | – | |
94 | If the meta-ethnography included lots of studies (≥ 50), reviewers state if they adapted their methods to remain grounded with original data/avoid losing conceptual richness (e.g. if they translated and synthesised original studies in clusters?) | 1 | – |
TABLE 15
Meta-ethnography phase 7 | Standard number | Reporting criteria | Meta-ethnography publications, n (%) | |
---|---|---|---|---|
Number of standards applicable to any meta-ethnography: 15 Number of standards applicable only to some meta-ethnographies: 0 | Standard met in full or in part | Standard not met or not reported | ||
Phase 7: expressing the synthesis | 95 | Include the term meta ethnography (or meta-ethnographic approach) in the title, abstract and/or keywords | 17 (89.4) | 2 (10.5) |
96 | Provide clear abstracts for readers: number of included studies stated | 17 (89.4) | 2 (10.5) | |
97 | Provide clear abstracts for readers: number of studies synthesised stated | 16 (84.2) | 3 (15.7) | |
98 | Provide clear abstracts for readers: differentiate reporting of primary study findings from new interpretation | 16 (84.2) | 3 (15.7) | |
99 | Provide clear abstracts for readers: connect key findings to policy or practice | 17 (89.4) | 2 (10.5) | |
100 | State target audience(s) for findings | 11 (57.8) | 8 (42.1) | |
101 | Present interpretive findings | 19 (100) | 0 (0) | |
102 | When quotations are used, state where they originate from (e.g. original study participants, original study authors, reviewer’s own field notes) | 16 (84.2) | 3 (15.7) | |
103 | Present to readers translations and syntheses clearly related to the original data | 17 (89.4) | 2 (10.5) | |
104 | State how reviewers encouraged reflexivity in the development of their new interpretation, for example deliberated their findings from different perspectives (e.g. their target audience, epistemology, academic discipline, health background, culturally, etc.) | 5 (26.3) | 14 (76.3) | |
105 | State how reviewers took steps to keep their interpretations grounded with original data | 6 (31.5) | 13 (68.4) | |
106 | Highlight limitations of the review to readers | 16 (84.2) | 3 (15.7) | |
107 | Discuss how limitations of the review may have affected validity and reliability, for example:
| 13 (68.4) | 6 (31.5) | |
108 | Possible limitations of the new theory, interpretation or model (e.g. if findings apply only to certain groups, countries) | 13 (68.4) | 6 (31.5) | |
109 | Clearly indicate how findings relate to potential end-users (e.g. application of findings to policy and/or practice) | 17 (89.4) | 2 (10.5) |
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