Open Access Research article

‘Trying to pin down jelly’ - exploring intuitive processes in quality assessment for meta-ethnography

Francine Toye1*, Kate Seers2, Nick Allcock34, Michelle Briggs5, Eloise Carr6, JoyAnn Andrews1 and Karen Barker1

Author Affiliations

1 Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, UK

2 Royal College of Nursing Research institute, School of Health & Social Studies, University of Warwick, Coventry, UK

3 Faculty of Medicine & Health Sciences School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Nottinghamshire, UK

4 School of Health and Life Sciences, Glasgow Caledonian University, Cowcaddens Road, Glasgow, UK

5 Institute of Health and Well Being, Leeds Metropolitan University, Leeds, UK

6 Faculty of Nursing, University of Calgary, Alberta, Canada

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BMC Medical Research Methodology 2013, 13:46  doi:10.1186/1471-2288-13-46

Published: 21 March 2013



Studies that systematically search for and synthesise qualitative research are becoming more evident in health care, and they can make an important contribution to patient care. However, there is still no agreement as to whether, or how we should appraise studies for inclusion. We aimed to explore the intuitive processes that determined the ‘quality’ of qualitative research for inclusion in qualitative research syntheses. We were particularly interested to explore the way that knowledge was constructed.


We used qualitative methods to explore the process of quality appraisal within a team of seven qualitative researchers funded to undertake a meta-ethnography of chronic non-malignant musculoskeletal pain. Team discussions took place monthly between October 2010 and June 2012 and were recorded and transcribed. Data was coded and organised using constant comparative method. The development of our conceptual analysis was both iterative and collaborative. The strength of this team approach to quality came from open and honest discussion, where team members felt free to agree, disagree, or change their position within the safety of the group.


We suggest two core facets of quality for inclusion in meta-ethnography - (1) Conceptual clarity; how clearly has the author articulated a concept that facilitates theoretical insight. (2) Interpretive rigour; fundamentally, can the interpretation ‘be trusted?’ Our findings showed that three important categories help the reader to judge interpretive rigour: (ii) What is the context of the interpretation? (ii) How inductive is the interpretation? (iii) Has the researcher challenged their interpretation?


We highlight that methods alone do not determine the quality of research for inclusion into a meta-ethnography. The strength of a concept and its capacity to facilitate theoretical insight is integral to meta-ethnography, and arguably to the quality of research. However, we suggest that to be judged ‘good enough’ there also needs to be some assurance that qualitative findings are more than simply anecdotal. Although our conceptual model was developed specifically for meta-ethnography, it may be transferable to other research methodologies.

Quality appraisal; Qualitative; Qualitative synthesis; Meta-ethnography