A methodological systematic review of meta-ethnography conduct to articulate the complex analytical phases

Background: Decision making in health and social care requires robust syntheses of both quantitative and qualitative evidence. Meta-ethnography is a seven-phase methodology for synthesising qualitative studies. Developed in 1988 by sociologists in education Noblit and Hare, meta-ethnography has evolved since its inception; it is now widely used in healthcare research and is gaining popularity in education research. The aim of this article is to provide up-to-date, in-depth guidance on conducting the complex analytic synthesis phases 4 to 6 of meta-ethnography through analysis of the latest methodological evidence. Methods: We report findings from a methodological systematic review conducted from 2015 to 2016. Fourteen databases and five other online resources were searched. Expansive searches were also conducted resulting in inclusion of 57 publications on meta-ethnography conduct and reporting from a range of academic disciplines published from 1988 to 2016. Results: Current guidance on applying meta-ethnography originates from a small group of researchers using the methodology in a health context. We identified that researchers have operationalised the analysis and synthesis methods of meta-ethnography – determining how studies are related (phase 4), translating studies into one another (phase 5), synthesising translations (phase 6) and line of argument synthesis - to suit their own syntheses resulting in variation in methods and their application. Empirical research is required to compare the impact of different methods of translation and synthesis. Some methods are potentially better at preserving links with the context and meaning of primary studies, a key principle of meta-ethnography. A meta-ethnography can and should include reciprocal and refutational translation and line of argument synthesis, rather than only one of these, to maximise the impact of its outputs. Conclusion: The current work is the first to articulate and differentiate the methodological variations and their application for different purposes and represents a significant advance in the understanding of the methodological application of meta-ethnography

Developing meta-ethnography reporting guidance for research and practice

Background:Meta-ethnography is a commonly used methodology for qualitative evidence synthesis. Research has identified that the quality of reporting of published meta-ethnographies is often poor and this has limited the utility of meta-ethnography findings to influence policy and practice.Objective(s):To develop guidance to improve the completeness and clarity of meta-ethnography reporting.Methods / DesignThe eMERGe study followed the recommended approach for developing health research reporting guidelines and used a systematic mixed methods approach. It comprised of: (1) a methodological systematic review of guidance in the conduct and reporting of meta-ethnography; (2) a review and audit of published meta-thnographies, along with interviews with meta-ethnography end-users, to identify good practice principles; (3) A consensus workshop and two eDelphi studies to agree guidance content; (4) development of the guidance table and explanatory notes.ResultsResults from the methodological systematic review and the audit of published meta-ethnographies revealed that more guidance was required around the reporting of all phases of meta-ethnography conduct, and in particular, the synthesis phases 4-6 (relating studies, translating studies into one another and synthesising translations). Following the guidance development process, the eMERGe Reporting Guidance was produced, consisting of 19 items grouped into the 7 phases of meta-ethnography.LimitationsThe finalised Guidance has not yet been evaluated in practice, therefore it is not possible at this stage to comment on their utility. However, we look forward to evaluating their uptake and usability in the future. ConclusionsThe eMERGe Reporting Guidance has been developed following a rigorous process in line with guideline development recommendations. The guidance is intended to improve the clarity and completeness of reporting of meta-ethnographies, to facilitate use of their findings to inform the design and delivery of services and interventions in health, social care and other iv fields. The eMERGe project developed a range of training material to support use of the guidance, which is freely available at www.emergeproject.org.Future workMeta-ethnography is an evolving qualitative evidence synthesis methodology, and future research will refine the guidance to accommodate future methodological developments. We will also investigate the impact of the eMERGe reporting guidance with a view to updating the guidance