|Summary of common methodologies for the synthesis of qualitative health research*|
|Methodology||Critical interpretive synthesis||Grounded theory synthesis||Meta-ethnography||Meta-study||Thematic synthesis|
|Key seminal methodology references||Dixon-woods et al. 2006 ||Kearney 2001 , Eaves 2001 ||Noblit and Hare 1988 , Britten et al. 2002 ||Paterson et al. 2001 ||Thomas and Harden 2008 |
|Philosophical positioning**||Subjective idealism – no single shared reality independent of multiple alterative human constructions||Objective idealism – a world of collectively shared understandings exists||Objective idealism – a world of collectively shared understandings exists||Subjective idealism – no single shared reality independent of multiple alterative human constructions||Critical realism – knowledge of reality is medicated by one’s beliefs and perspectives|
|Literature search||Theoretical sampling||Theoretical sampling||Non-specified||Not-specified||Systematic, comprehensive|
|Quality appraisal||The degree to which the research findings can inform theory development||Implicit judgement about the context, quality and usefulness of the study||Judgement based on relevance; CASP||Focuses on rigour and the epistemological soundness of the research methods||Criteria related to aims, context, rationale, methods and findings, reliability, validity, appropriateness of methods for ensuring findings are grounded in participant perspectives|
|Analysis techniques and concepts||· Concurrent iteration of the research questions||· Concurrent data collection and analysis||· Reciprocal translational analysis (translation of concepts from individual studies – 1st/2nd order constructs)||· Analyse findings – meta-data-analysis||· Line by line coding of text from primary studies|
|· Extract data and summarise papers||· Theory is derived inductively from the data||· Refutational synthesis (explore and explain contradictions between studies – 1st/2nd order constructs)||· Analyse methods – meta-method)||· Free codes organised into descriptive themes|
|· Define and apply codes||· Constant comparison of data||· Lines of argument (grounded theorising based on synthesising translations)||· Analyse theory – meta-theory||· Further interpretation to develop analytical themes|
|· Develop a critique, generate themes||· Bring together all three components of the analysis|
|Synthesis output||· New theoretical conceptualisation – synthetic construct||· Generation of a new, higher-level grounded theory||· New insights – 3rd order constructs||· Account for differences in research findings||· Analytical themes that offer a new interpretation that goes beyond the primary studies|
|· New interpretation of phenomena studied|
|Topic areas and study references†||Access to healthcare by vulnerable groups , pain management ||Domestic violence , caregiving ||Medicine-taking , patients’ help-seeking experiences in cancer presentation , palliative care ||Chronic illness experience , influences on shared decisions making , adolescent health ||Children’s experiences of health eating , chronic kidney disease , people’s understanding of cancer risk , organ transplantation , patient-physician relationships |
*This is not a complete list of methodologies as methodologies for the synthesis of qualitative health research are wide ranging; **Adapted from Barnett-Page and Thomas  and Spencer et al. . †References selected to reflect a range of topic areas in health research.
Tong et al.
Tong et al. BMC Medical Research Methodology 2012 12:181 doi:10.1186/1471-2288-12-181