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Open Access Correspondence

“Best fit” framework synthesis: refining the method

Christopher Carroll1*, Andrew Booth1, Joanna Leaviss1 and Jo Rick2

Author Affiliations

1 Health Economics and Decision Science (HEDS), School of Health and Related Research (ScHARR), Regent Court, Regent Street, Sheffield, S1 4DA, UK

2 Health Sciences Research Group - Primary Care, School of Community Based Medicine, University of Manchester, Williamson Building, Manchester, M13 9PL, UK

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BMC Medical Research Methodology 2013, 13:37  doi:10.1186/1471-2288-13-37

Published: 13 March 2013

Abstract

Background

Following publication of the first worked example of the “best fit” method of evidence synthesis for the systematic review of qualitative evidence in this journal, the originators of the method identified a need to specify more fully some aspects of this particular derivative of framework synthesis.

Methods and Results

We therefore present a second such worked example in which all techniques are defined and explained, and their appropriateness is assessed. Specified features of the method include the development of new techniques to identify theories in a systematic manner; the creation of an a priori framework for the synthesis; and the “testing” of the synthesis. An innovative combination of existing methods of quality assessment, analysis and synthesis is used to complete the process. This second worked example was a qualitative evidence synthesis of employees’ views of workplace smoking cessation interventions, in which the “best fit” method was found to be practical and fit for purpose.

Conclusions

The method is suited to producing context-specific conceptual models for describing or explaining the decision-making and health behaviours of patients and other groups. It offers a pragmatic means of conducting rapid qualitative evidence synthesis and generating programme theories relating to intervention effectiveness, which might be of relevance both to researchers and policy-makers.

Keywords:
Systematic review; Qualitative research; Methods; Framework synthesis; Thematic analysis; Sensitivity analysis; Smoking cessation; Critical appraisal; Theory