Original Title: Metodología para incorporar los estudios cualitativos en la evaluación de tecnologías sanitarias

Authors' objectives: The main goal of this report is to identify different procedures used to combine and synthesize studies and reports based on qualitative research. A secondary goal is to display the wide spectrum of problems arising during the systematic review and synthesis of information available in qualitative research

Authors' results and conclusions: MAIN RESULTS: In this report, different methods used to combine and synthesize qualitative research are described in detail. Ninety-one studies, out of 253 initially located, were included in the analysis. Of the included studies, 37 were mainly methodological, whereas 54 were qualitative studies in which some techniques for combining and synthesizing results were applied. The main methods identify for combining qualitative results were metaethnography, meta-synthesis, and meta-study; there were also a reduced number of publications using meta-interpretation and aggregation review. Other non-specific methods for combined analysis were identified: on one hand, techniques currently used in the systematic reviews of quantitative studies, and, on the other hand, qualitative research methods used for primary qualitative studies applied to secondary studies. In order to improve the retrieval of qualitative studies in the systematic reviews, some researchers recommend to be exhaustive and to promote searches that are of low specificity, whereas other relies more on an opportunistic approach to the searches. Nowadays, several sets of filters have been developed for bibliographic retrieval that contributes to improve the specificity of the results. Nevertheless, the lack of development, reaching consensus and the incorporation of specific terms for indexing are a handicap in the systematic identification of qualitative research in the databases. Another relevant issue is the evaluation of the quality of qualitative research. In this respect there exists a wide range of opinions, from those who maintain the great difficulties in evaluating their quality, to the other end where some scientist are using even quantitative scales, similar to the used for the evaluation of quantitative research. Therefore, there is a lack of consensus on whether the quality of the qualitative research should, or should not, be evaluated, and on which could be the criteria that should be used, or if papers should be excluded due to “low quality” because of the difficulties to achieve consensus about what is a good qualitative study. CONCLUSIONS: In this report several methods used for the combination or synthesis of qualitative studies, used by researchers in several countries are identify and described. From 1995 onwards, there is a growing interest in developing and reaching consensus for explicit procedures that allow combining or synthesizing the results of qualitative studies, in the same way that systematic reviews of quantitative studies are nowadays standard and well defined. The main problems in this direction are identify in this report; namely, the difficulties for a complete, specific and sensitive retrieval of publications in the field of qualitative research on health, the lack of uniform criteria for the evaluation of the quality of those studies, and the large variety of procedures that can be used to combine the results of this type of research. A number of different researchers from different geographical locations and institutions are interested in developing methods that allows for the incorporation of qualitative results in order to complete the information gathered trough quantitative research, in order to foster better information processes for decision taking in HTA. Which seems evident at the present state is that it is not possible to carry on a systematic review of qualitative studies in the same way the systematic review of quantitative research is currently done. To advance in this process it is of paramount importance to reach a consensus on the terminology to be used. This will facilitate the communication between researchers within the qualitative domain, as well as between them and those of the quantitative domain. Furthermore, whereas a common approach between people promoting the different methods for combining and synthesizing qualitative research is not more developed, it is important for the scientists trying to do so, to make explicit statements for the decisions and methods used in their systematic review of qualitative studies.

Authors' methods: Systematic review of different methods used in the combination and synthesis of qualitative studies

Project Status: Completed

Year Published: 2007

URL for published report: https://sescs.es/metodologia-para-incorporar-los-estudios-cualitativos-en-la-evaluacion-de-tecnologias-sanitarias/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es