Systematic Reviews and Review Types: What is a Meta-Synthesis?

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Other names for a Meta-Synthesis

Meta-synthesis, Meta-ethnography, Qualitative Evidence Synthesis, Qualitative Meta-Synthesis, Meta narrative review (related)

What is a Meta-Synthesis?

A meta-synteses is bringing together qualitative data to form a new interpretation of the research field.  It helps to build new theories and is not to be confused with a meta-analysis which tests a hypothesis using quantitative data.  It primarily generates theory such as program theory, implementation theory, or an explanatory theory of why the intervention works or not, hypothesis for future testing or comparison with trial outcomes.

Meta-syntheses are best designed for:

  • To re-interpret meaning across many qualitative studies.

(Source:  S. Atkins et al (2008))

What is a Meta-Synthesis? Outline of Stages

Timeframe: 12+ months or less. *Varies beyond the type of review. Depends on many factors such as but not limited to: resources available, the quantity and quality of the literature, and the expertise or experience of reviewers” (Grant et al. 2009)

Question:  May use PICo (Population, Interest, Context), SPICE, SPIDER or PerSPEcTiFquestion formats, “A clearly formulated question helps to set boundaries for the scope and depth of a meta-ethnography” (Atkins S.)

Sources and searches: 

Refer to the 7 S Framework of Qualitative Searching by Booth (2016) https://systematicreviewsjournal.biomedcentral.com/articles/10.1186/s13643-016-0249-x

Search specifically for qualitative studies, may include more grey literature, book chapters or conference proceedings or theses. 

Selection: Different screening process–includes repeated reading of articles to connect and record concepts or themes. 

Appraisal: Focus is on the translation of studies and then systematically compared or ‘translated’ within and across studies while retaining the structure of the relationships between central concepts/themes and includes a ‘thematic analysis’.

Synthesis: Qualitative Differs from a Meta-Analysis (Quantitative) “The goal is not aggregative in the sense of ‘adding studies together’ as with a meta-analysis.  On the contrary, it is interpretative in broadening understanding of a particular phenomenon.” (Source: Grant et al (2009))

There are 3 types of synthesis that may be used.  A second level of synthesis is possible.

  1. Reciprocal Translation: Concepts in one study can incorporate those of another.
  2. Refutational Translation: Concepts in different studies contradict one another.
  3. Line of Argument Synthesis: Studies identify different aspects of the topic that can be drawn together in a new interpretation.

(Source: France EF, Ring N et al (1988))

For more about the reporting guidelines for a Meta-Synthesis or Meta-Ethnography please visit the eMERGe Project website at http://emergeproject.org/ and ENTREQ for the reporting of qualitative evidence syntheses. 

There is also the Cochrane Qualitative & Implementation Methods Group: http://methods.cochrane.org/qi/

SPICE question format

SPIDER question format

PerSPEcTiF question format

PICO and Beyond Template– For writing a question using formats other than PICO

Resources:

Atkins S, Lewin S, Smith H, et al.  Conducting a meta-ethnography of qualitative literature: lessons learnt.  BMC Medical Research Methodology.  2008; 8:21.

Grant MJ, Booth A. A typology of reviews: an analysis of 14 review types and associated methodologiesHealth Information and Libraries Journal.  2009; 26(2):91-108.

Noblit GW, Hare RD. Meta-ethnography: synthesizing qualitative studies. Newbury Park, California: Sage Publications, Inc.; 1988.

The seven phases of Noblit and Hare’s meta-ethnography (meta-syntheses) approach

The seven phases of Noblit and Hare's meta-ethnography approach

(Source: France EF, Ring N et al (1988))

Limitations of a Meta-Synthesis

  • Only appropriate for high-quality qualitative studies
  • Can only accommodate a limited number of primary studies, choice of a meta-ethnography may not be confirmed until pool of evidence known
  • Requires significant methodological skill and experience with qualitative methods
  • May take time to engage with the evidence and develop theory
  • Requires further interpretation by policy makers and practitioners

(Source: M. Petticrew et al (2013) and Li T. et al (2001))

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