Checklists embedded in a software program to guide qualitative evidence synthesis:
Some evidence synthesis organisations have developed and incorporated a checklist in the software they make available to assist reviewers with the synthesis of qualitative findings. Typically, potential reviewers need to register to be able to use it. However, the instruments are also available outside the software program on the websites of both organisations1.
Examples:
QARI software developed by the Joanna Briggs Institute, Australia URL: http://www.joannabriggs.edu.au/services/sumari.php
1
URL: http://www.joannabriggs.edu.au/cqrmg/tools_3.html. A detailed guide on how to conduct a QARI supported Systematic Review, including a detailed explanation of the10 critical appraisal criteria, can be found on the JBI-website: http://www.joannabriggs.edu.au/pdf/sumari_user_guide.pdf URL for instrument on process evaluation:
http://eppi.ioe.ac.uk/cms/default.aspx?tabid=2370&language=en-US. Tools exist which help to assess quality along three dimensions: quality of reporting, sufficiency of strategies for increasing
methodological rigour, and the extent to which study methods and findings are appropriate to answer the review question (For an example, see Harden et al 2009 study).
Used by: Pearson A, Porritt KA, Doran D, Vincent L, Craig D, Tucker D, Long L, Henstridge V. A comprehensive systematic review of evidence on the structure, process, characteristics and composition of a nursing team that fosters a healthy environment. International Journal of Evidence-Based Healthcare 2006; 4(2): 118-59.
Rhodes LG et al.Patient subjective experience and satisfaction during the perioperative period in the day surgery setting: a systematic review. Int J Nurs Pract 2006; 12(4): 178-92.
EPPI-reviewer developed by the EPPI Centre, United Kingdom
URL: http://eppi.ioe.ac.uk/eppireviewer/login.aspx
Used by: Bradley P, Nordheim L, De La Harpa D, Innvaer S & Thompson C. A systematic review of qualitative literature on educational interventions for evidence-based practice. Learning in Health & Social Care 2005: 4(2):89-109.
Harden A, Brunton G, Fletcher A, Oakley A. Teenage pregnancy and social disadvantage: a systematic review integrating trials and
qualitative studies. British Medical Journal Oct 2009.
Other online available appraisal instruments:
Most of the instruments in this selection are easily accessible and clearly define what is meant by each individual criterion listed. As such, they may be particularly useful if reviewers with little experience of qualitative research are required to complete an assessment.
Examples:
Critical Appraisal Skills Programme (CASP):
http://www.phru.nhs.uk/Doc_Links/Qualitative%20Appraisal%20Tool.pdf
Used by: Kane GA et al. Parenting programmes: a systematic review and synthesis of qualitative research. Child Care Health and
Development 2007; 33(6): 784-793.
Modified versions of CASP, used by:
Campbell R, Pound P, Pope C, Britten N, Pill R, Morgan M, Donovan J. Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care. Social Science and Medicine 2003; 56: 671-84.
Malpass A, Shaw A, Sharp D, Walter F, Feder G, Ridd M, Kessler D. ‘Medication career" or "Moral career"? The two sides of managing antidepressants: A meta-ethnography of patients' experience of antidepressants. Soc Sci Med. 2009; 68(1):154-68.
Quality Framework UK Cabinet Office
http://www.gsr.gov.uk/downloads/evaluating_policy/a_quality_framework.pdf
Used by: MacEachen E et al. Systematic review of the qualitative literature on return to work after injury. Scandinavian Journal of Work Environment & Health 2006; 32(4): 257-269.
Evaluation Tool for Qualitative Studies
http://www.fhsc.salford.ac.uk/hcprdu/tools/qualitative.htm
Used by: McInnes RJ & Chambers JA. Supporting breastfeeding mothers: qualitative synthesis. Journal of Advanced Nursing 2008; 62(4): 407-427.
Checklists developed by academics and commonly used in published qualitative evidence syntheses: Such checklists have been selected and utilised by other researchers in the specific context of an evidence synthesis.
Examples:
The Blaxter (1996) criteria for the evaluation of qualitative research papers, used by:
Gately C et al. Integration of devices into long-term condition
management: a synthesis of qualitative studies. Chronic Illn 2008; 4(2): 135-48.
Khan N et al. Guided self-help in primary care mental health - Meta- synthesis of qualitative studies of patient experience. British Journal of Psychiatry 2007; 191: 206-211.
Barrosso J, Powell Cope GM. Meta-synthesis of qualitative research on living with HIV infection. Qualitative Health Research 2000; 10: 340-53.
Thorne S, Paterson B. Shifting images of chronic illness. Image: Journal of Nursing Scholarship 1998: 30; 173-8.
Hildingh C et al. Women's experiences of recovery after myocardial infarction: a meta-synthesis. Heart Lung 2007; 36(6): 410-7.
Howard AF, Balneaves LG, Bottorff JL. Ethnocultural women’s
experiences of breast cancer: a qualitative meta-study. Cancer nursing 2007 30(4): E27-35.
The Popay et al (1998) criteria, used by:
Attree P. Low-income mothers, nutrition and health: a systematic review of qualitative evidence. Maternal and Child Nutrition 2005 1(4): 227-240.
Sim J & Madden S. Illness experience in fibromyalgia syndrome: A metasynthesis of qualitative studies." Social Science & Medicine 2008; 67(1): 57-67.
Yu D et al. Living with chronic heart failure: a review of qualitative studies of older people. J Adv Nurs 2008; 61(5): 474-83.
Humphreys A et al. A systematic review and meta-synthesis:
evaluating the effectiveness of nurse, midwife/allied health professional consultants. Journal of Clinical Nursing 2007; 16(10): 1792-1808.
Metcalfe A et al. Family communication between children and their parents about inherited genetic conditions: a meta-synthesis of the research. Eur J Hum Genet 2008; 16(10): 1193-200.
Robinson L. & Spilsbury K. Systematic review of the perceptions and experiences of accessing health services by adult victims of domestic violence. Health Soc Care Community 2008; 16(1): 16-30.
Section 4: Integrating outcomes of critical appraisal in a systematic
review.
In a ‘best case’ scenario a qualitative synthesis or primary study will achieve a positive assessment or score for each of the criteria against which it has been
assessed according to the critical appraisal instrument used. However, this will most likely not be the case for the majority of studies and researchers need to be aware of the fact that the assessment or score might depend on the instrument that has been used, which increases the value of involving a researcher with a qualitative
information or it is clear that the study is weak when matched against a certain criterion e.g. because of a methodological flaw a decision needs to be made whether to include the study or not.