The purpose of the Qualitative Metasynthesis Project was to clarify, refine, and develop new analytic and interpretive techniques to synthesize qualitative research findings. Studies of HIV-positive women were used to develop these techniques, and studies of women and couples receiving positive prenatal diagnoses were used to evaluate and refine them. To begin the project, we drew from procedures traditionally associated with research synthesis to set inclusion criteria and to search for and retrieve relevant literature, and from available guidelines used to evaluate qualitative studies. We used reflexive accounting practices, such as the maintenance of an audit trail, think/talk aloud and negotiated consensus processes, and peer review, throughout the project. As we developed procedures, a six-member panel of experts evaluated them with purposeful samples of research reports in the study. An additional “test” of our procedures was to use them to complete several research syntheses.
This paper explores practical methodological issues which arise from the application of systematic review and metaâsynthesis techniques to qualitative research studies in the context of a pragmatic health services research question.
However, relatively little has been written about the methodology of systematically reviewing and metaâsynthesizing qualitative research studies, and about the practical issues which arise in the course of these processes.