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Qualitative Evidence Synthesis: Harnessing the Qualitative Research and Systematic Review Research Traditions

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Qualitative Evidence Synthesis: Harnessing the Qualitative Research and Systematic Review Research Traditions Acknowledging a ‘Dual Heritage’ for Qualitative Evidence Synthesis: Harnessing the Qualitative Research and Systematic Review Research Traditions Andrew Booth Thesis submitted to the University of Sheffield for the degree of Doctor of Philosophy by Publication School of Health and Related Research June 2013 A ‘Dual Heritage’ for QES Table of Contents Acknowledgements............................................................................................................................. 4 An Explanation of Terminology ...................................................................................................... 5 Summary ...................................................................................................................................................... 6 Abbreviations ......................................................................................................................................... 7 Glossary ................................................................................................................................................... 8 Relevant publications and declaration of contribution ......................................................... 10 Methodological papers ................................................................................................................... 10 Case studies as methodology lead .............................................................................................. 13 Coherence of Work ........................................................................................................................... 14 1. Background ........................................................................................................................................ 15 1.1 Qualitative Systematic Reviews: same family, different heritage? .......................... 17 1.2 Towards a ‘Dual Heritage’ model of Qualitative Evidence Synthesis ....................18 2. Context for the Featured Papers ................................................................................................ 23 3. On Searching and Sampling .......................................................................................................... 25 3.1 Limitations of Papers M1 and M2 .......................................................................................... 32 3.2 Summary ........................................................................................................................................ 33 4. On Quality Assessment ................................................................................................................ 34 4.1 Role of the Case Studies .......................................................................................................... 38 4.2 Limitations of Paper M3 ......................................................................................................... 40 4.3 Summary ........................................................................................................................................ 42 5. On Synthesis ........................................................................................................................................ 43 5.1 Towards a pragmatic method of synthesis ..................................................................... 44 5.2 Exploring heterogeneity .......................................................................................................... 45 5.3 Role of the Case Studies ......................................................................................................... 46 5.4 Limitations of Papers M4 and M5........................................................................................ 49 5.5 Summary ......................................................................................................................................... 51 6. Improving Standards of Reporting ............................................................................................ 52 6.1 Summary ......................................................................................................................................... 55 -2- A ‘Dual Heritage’ for QES 7. Some Reflections on the Dual Heritage model ..................................................................... 57 8. Towards a Future Research Agenda ......................................................................................... 59 9. Conclusion ............................................................................................................................................ 62 References ................................................................................................................................................. 66 Appendix A – Summary of Permissions ................................................................................... 82 Appendix B - Paper M1 (“Brimful of Starlite”) ....................................................................... 83 Appendix C - Paper M2 (Synthesizing Qualitative Research) ........................................84 Appendix D - Paper M3 (Should We Exclude Inadequately-Reported Studies?) . 85 Appendix E - Paper M4 (A Worked Example of “Best Fit”…Synthesis) ..................... 86 Appendix F - Paper M5 (Desperately Seeking Dissonance) ........................................... 87 Figure 1 - Relationship between Included Papers .......................................................................... 12 Table 1 - Potential Contributions to Qualitative Evidence Synthesis of the respective heritages .......................................................................................................................................................... 22 Table 2 - Synthesis Methods with Appropriate Sampling Methods ..................................... 30 Table 3 - Strategies for exploring heterogeneity within a QES (from Paper M5) .......... 46 Table 4 - Characteristics of the Case Studies ................................................................................48 Table 5 - Elements of the STARLITE mnemonic (from Paper M1) ........................................ 53 -3- A ‘Dual Heritage’ for QES Acknowledgements Firstly, I would like to thank Dr Eva Kaltenthaler for being an excellent and most supportive advisor throughout my PhD study. I would also like to thank my co- convenors of the Cochrane Collaboration Qualitative Research Methods Group, Professor Jane Noyes, Dr Karin Hannes and Dr Janet Harris, for acting as external readers and Professor Alicia O’Cathain, Dr Christopher Carroll, Dr Emma Knowles and Dr Susan Baxter for acting as ScHARR readers. Indeed particular thanks are due to Christopher Carroll with whom innumerable kitchen and corridor conversations have helped turn our opportunistic methodology research into a reality. I have benefited greatly over the past decade from the challenging debates and discussions I have had with colleagues on various funded projects, with a particular debt to Professor Mary Dixon-Woods and the University of Leicester Quantitative and Qualitative Review Methods Team who helped me to embark on my journey of discovery. Thank you too to all my co-authors on the included case studies. Thanks to my family, wife Sandra and children, James, Thomas and Eloise for tolerating my extended absence spent in the garret that is our home office. Finally this PhD by Publications was undertaken during a period of University of Sheffield supported study leave (April 2012 – September 2012) and I would like to thank Professors Alan Brennan, Simon Dixon and Jon Nicholl for being instrumental in securing this protected time. -4- A ‘Dual Heritage’ for QES An Explanation of Terminology Although systematic reviews constitute a collective endeavour, this Thesis highlights a unique, original and personal contribution to knowledge of evidence synthesis. The following reporting conventions support this focus. The five featured Methodological papers are designated with the prefix of M e.g. Paper M1. Methodological issues are exemplified through five case studies labelled as Case Study 1 etcetera. The Methodological papers are indicated in the References with the entire reference in bold accompanied by three asterisks e.g. *** Booth A (2006) “Brimful of Starlite” etc. Additional relevant supporting papers that underpin the Candidate’s personal contribution are indicated within the References by the Candidate’s name being highlighted in bold e.g. “Carroll C, Booth A, Papaioannou D, Sutton A, & Wong R (2009a) etc”. Furthermore such references are indicated within the body of the text by the addition of the Candidates’s name to the First Author et al convention, with ellipsis to indicate authorial position subsequent to second author, e.g. “Dixon-Woods…Booth et al (2006)”. This convention enables the reader to place the featured papers within a programme of interconnected research and yet indicates transparently the extent of engagement with published work by, and with, other researchers. Finally, although ‘qualitative systematic review’ persists as the most common umbrella term for the methodology described in this Thesis it carries unwanted connotations that the included papers seek to challenge, namely that qualitative research can be mechanistically ‘squeezed’ within a conventional systematic review template. Unless constrained by the terminology used in source articles, this Thesis implements the decision, taken by the Author with other co-convenors
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