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Supplementary Resources
for Qualitative EvidenceSupplement B

to Chapter 30 Syntheses

T he field of qualitative evidence synthesis is very bumpy terrain. Literally dozens of terms
for qualitative synthesis methods have emerged,
referring to a disconcerting array of approaches.
It is beyond the scope of this general textbook to
describe each approach—indeed, there is no con-
sensus on definitions, nor on which approaches
are likely to remain in the synthesis repertoire in
the years ahead. As noted in the textbook, there
is not even consensus on what to call the entire
enterprise. The most frequently used “umbrella”
terms are qualitative metasynthesis, qualitative
systematic review, qualitative evidence synthe-
sis, and qualitative research synthesis (Booth et
al., 2016); other terms include qualitative meta-
analysis and qualitative data aggregation (Thorne,
2017). The leading organizations involved with
systematic reviews, the Cochrane Collaboration
and the Joanna Briggs Institute, typically use the
umbrella term qualitative evidence synthesis.
In nursing, the term metasynthesis has predom-
inated. Nurse researchers have contributed more
to the field of qualitative research synthesis than
scholars in other health-related disciplines (Tricco
et al., 2016).

Several groups of researchers have made
efforts to compare different qualitative review
approaches, often using systematic review meth-
ods themselves. For example, a large group of

scholars from Canada (Kastner et al., 2016; Tricco
et al., 2016) undertook a scoping review in which
409 articles describing 25 qualitative synthe-
sis methods (some were mixed studies reviews)
were analyzed. In the United Kingdom, another
group mapped the qualitative synthesis terrain and
made explicit comparisons among the approaches
along several dimensions (Booth et al., 2016).
We identified several other similar comparative
efforts (Barnett-Page & Thomas, 2009; Hannes
& Lockwood, 2011; Saini & Schlonsky, 2012;
Schick-Makaroff et al., 2016), and others are likely
to emerge as the field struggles to attain greater
clarity and consensus.

We have created a table that indicates which
resources provide comparative information about
approaches to qualitative synthesis along several
dimensions of variation. Table 1 shows review
citations for 14 qualitative synthesis approaches.
Our table does not include all approaches that
were compared in the review articles. For example,
one approach to qualitative synthesis, referred to
as content analysis, was included in comparative
tables in Hannes and Lockwood’s (2011) article but
not in any of the others. We did not include this
approach in Table 1.

A quick glance at Table 1 shows that certain
approaches have received a lot of attention in these
comparative reviews—especially grounded formal

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ne
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-P
ag

e,
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.,
&

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m
as

, J
. (

20
09

).
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et
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ds
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or
t

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s

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th

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.

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, A

.,
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, J
.,

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.,

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.,
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ah
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.,

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. (

20
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).
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7.

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20
11

).
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as

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, M
.,

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.,

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, C
.,

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s,

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.,

&
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ri
cc

o,
A

. (
20

16
).

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3,

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, F

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ur

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1.

S
ai

ni
, M

.,
&

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hl

on
sk

y,
A

. (
20

12
).

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sy

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th

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f

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li

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. O

xf
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:

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U
ni

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rs

it
y

P
re

ss
, T

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2
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.

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ch

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k-

M
ak

ar
of

f,
K

.,
M

ac
D

on
al

d,
M

.,
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lu
m

m
er

, M
.,

B
ur

ge
ss

, J
.,

&
N

ea
nd

er
, W

. (
20

16
).

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w

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IM
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, 3

, 1
72

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15

. A
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cc
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A
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, C
.,

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J
.,

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og

o,
E

.,
M

ac
D

on
al

d,
H

.,
L

il
li

e,
E

.,

K
as

tn
er

, M
. (

20
16

).
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s
co

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w

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3,

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9–

28
, T

ab
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s
2

&
3

.
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s
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20
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.
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ss
, a

d
im

en
si

on
d

is
cu

ss
ed

i
n

B
ar

ne
tt

-J
on

es
e

t
al

.,
20

09
.

d C
at

eg
or

ie
s

in
cl

ud
e

G
en

er
at

in
g

th
eo

ry
, E

xp
lo

ri
ng

t
he

or
y,

a
nd

T
es

ti
ng

t
he

or
y;

r
at

in
gs

a
re

N
ot

r
eq

ui
re

d,
E

ss
en

ti
al

, o
r

U
nc

er
ta

in
.

e S
om

e
(e

.g
.,

B
oo

th
e

t
al

.)
c

on
si

de
r

m
et

as
yn

th
es

is
a

s
an

u
m

br
el

la
t

er
m

. B
oo

th
i

nc
lu

de
d

an
a

pp
ro

ac
h

ca
ll

ed

Q
ua

li
ta

ti
ve

i
nt

er
pr

et
iv

e
m

et
as

yn
th

es
is

,”
w

hi
ch

i
s

th
e

m
et

ho
d

re
fe

rr
ed

t
o

w
he

n
B

oo
th

i
s

ci
te

d
fo

r
m

et
as

yn
th

es
is

.

https://bmcmedresmethodol.biomedcentral.com/track/pdf/10.1186/1471-2288-9-59

https://bmcmedresmethodol.biomedcentral.com/track/pdf/10.1186/1471-2288-9-59

http://www.integrate-hta.eu/downloads/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5690272/pdf/publichealth-03-01-172.pdf

30-4 � PART 6 Building an Evidence Base for Nursing Practice

theory, critical interpretive synthesis, metastudy,
and meta-ethnography. The approach adopted by
the Joanna Briggs Institute—meta-aggregation—
was classified in the category called metasummary
in the large Canadian scoping review (e.g., Kastner
et al., 2016; Tricco et al.), but other reviewers dis-
tinguished the two.

In Table 1, we included comparisons among
the approaches for 12 dimensions. Other dimen-
sions that were compared in the various reviews
are not shown in Table 1, to keep the table more
manageable. For example, Tricco et al. (2016) com-
pared the synthesis approaches with respect to dis-
ciplinary roots and Booth et al. (2016) compared
approaches with respect to resource requirements
and time demands.

A few caveats are in order. First, for any given
cell in the table, we make no claim that the infor-
mation provided is comparable across the refer-
ences. For instance, review teams differed in how
they described the purpose of a particular approach.
Here is one example, in which four review teams
described the purpose of a metastudy:

l “The analysis of research findings, methods, and
theory across qualitative studies are compared
and contrasted to create a new interpretation”
(Schick-Makaroff et al., 2016, p. 202, p. 202).

l “To seek and reveal similarities and differ-
ences and build new interpretations” (Hannes &
Lockwood, 2011, p. 1635, p. 1635).

l “To develop new knowledge, theoretical inter-
pretations, and understanding through criti-
cally analyzing and synthesizing qualitative
studies within sociocultural contexts” (Saini &
Schlonsky, 2012, p. 46).

l To “explore understanding; explore perceptions;
explore a phenomenon; review and evaluate;
explore synthesis methods” (Tricco et al., 2016,
p. 26).

Another issue is that some of the dimensions
involve categorical comparisons—and the cate-
gories are not the same from one review group to
the next. For example, Barnett-Page and Thomas
(2009) used five categories for comparisons in
the epistemology dimension: Subjective idealism,
objective idealism, critical realism, scientific real-
ism, and naïve realism. In Booth et al.’s (2016)
review, by contrast, epistemological distinctions
were included in several separate categories, such
as idealist versus realist and degree of depen-
dence on epistemology (high, moderate, low).
Metastudies were classified as Subjective idealism
by Barnett-Page and Thomas, and as Idealist and
Moderate dependence on epistemology by Booth
and colleagues.

Finally, we do not attest to the accuracy of
the information in the comparative tables in the
reviews. For example, Booth and colleagues
(2016) claim in the comparisons that grounded
formal theory and meta-ethnography involve gen-
erating theory, exploring theory, and testing the-
ory—but that metastudy does “not require” any of
these. We make no comment on these judgments.
Original sources for the various approaches should
always be checked before drawing firm conclu-
sions. The comparative tables should be a starting
point for learning about the features of the various
approaches.

Table 2 provides at least one reference for each
approach included in Table 1. The second col-
umn lists a reference from the Booth et al. (2016)
review that those researchers designated as a “core
methodological text” (p. 32) for most approaches
mentioned in the first column. The third column
provides an additional reference or, for approaches
not included in the Booth et al. review, a single
reference. Whenever possible, a link to retrieve
the reference is also included.

T
A

B
L

E
2

M
a

jo
r

R
e

fe
re

n
ce

(s
)

fo
r

E
a

ch
Q

u
a

li
ta

ti
v

e
E

v
id

e
n

ce
S

y
n

th
e

si
s

A
p

p
ro

a
ch

in
T

a
b

le
1

ph
il

os
op

hi
ca

l
fo

un
da

ti
on

f
or

t
he

J
oa

nn
a

B
ri

gg
s

m
et

a-
ag

gr
eg

at
iv

e
ap

pr
oa

ch
t

o
qu

al
it

at
iv

e
ev

id
en

ce
s

yn
th

es
is

.
Jo

u
rn

a
l

o
f

A
d
va

n
ce

d
N

u
rs

in
g,

6
7
, 1

63
2–

16
42

.

C
ar

ro
ll

, C
.,

B
oo

th
, A

.,
L

ea
vi

ss
, J

.,
&

R
ic

k,
J

. (
20

13
).


B

es
t

fi
t”

f
ra

m
ew

or
k

sy
nt

he
si

s:
R

ef
in

in
g

th
e

m
et

ho
d.

B
M

C

M
ed

ic
a
l

R
es

ea
rc

h
M

et
h
o
d
o
lo

g
y,

1
3
, 3

7.
h

tt
ps

:/
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w
w

.
nc

bi
.n

lm
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ih
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C
36

18
12

6/
pd

f/
14

71

22
88

-1
3-

37
.p

df
.

K
ea

rn
ey

, M
. (

20
01

).
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ew
d

ir
ec

ti
on

s
in

g
ro

un
de

d
fo

rm
al

th

eo
ry

. N
ew

d
ir

ec
ti

on
s

in
g

ro
un

de
d

fo
rm

al
t

he
or

y.
I

n
S

ch
re

ib
er

&
P

. S
te

rn
(

E
ds

.)
.

R
.

U
si

n
g
g

ro
u
n
d
ed

t
h
eo

ry

in
n

u
rs

in
g
(

pp
. 2

37
–2

46
).

N
ew

Y
or

k:
S

pr
in

ge
r.

L
oc

kw
oo

d,
C

.,
P

or
ri

t,
K

.,
M

un
n,

Z
.,

R
it

te
nm

ey
er

, L
.,

S
al

m
on

d,
S

.,
L

ov
ed

ay
, H

.,
C

ar
ri

er
, D

. S
ys

te
m

at
ic

re

vi
ew

s
of

q
ua

li
ta

ti
ve

e
vi

de
nc

e.
I

n
A

ro
m

at
ar

is
, W

. &

M
un

n,
Z

. (
E

ds
.)

. J
o
a
n
n
a
B

ri
gg

s
In

st
it

u
te

R
ev

ie
w

er
’s

M

a
n
u
a
l.

h
tt

ps
:/

/r
ev

ie
w

er
sm

an
ua

l.
jo

an
na

br
ig

gs
.o

rg
/.

N
A

M
E

O
F

A
P

P
R

O
A

C
H

C

O
R

E
C

IT
A

T
IO

N
(

F
R

O
M

B
O

O
T

H
E

T
A

L
.,

2
0

1
6

),
W

IT
H

L
IN

K
W

H
E

N
R

E
F

E
R

E
N

C
E

I
S

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P

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N

-A
C

C
E

S
S

O

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H

E
R

C
IT

A
T

IO
N

C
on

ce
p

t
an

al
ys

is
/

sy
n

th
es

is

W
al

ke
r,

L
.,

&
A

va
nt

, K
. (

20
10

).
S

tr
a
te

g
ie

s
fo

r
th

eo
ry

co

n
st

ru
ct

io
n
i

n
n

u
rs

in
g.

(
5t

h
ed

.)
. U

pp
er

S
ad

dl
e

R
ei

ve
r,

N

J:
P

ea
rs

on
.

C
ri

ti
ca

l
in

te
rp

re
ti

ve

sy
n

th
es

is

D
ix

on
-W

oo
ds

, M
.,

C
av

er
s,

D
.,

&
A

ga
rw

al
, S

.,
A

nn
an

da
le

,
E

.,
A

rt
hu

r,
A

.,
H

ar
ve

y,
J

.,

S
ut

to
n,

A
. (

20
06

).

C
on

du
ct

in
g

a
cr

it
ic

al
i

nt
er

pr
et

iv
e

sy
nt

he
si

s
of

t
he

li

te
ra

tu
re

o
n

ac
ce

ss
t

o
he

al
th

ca
re

b
y

vu
ln

er
ab

le
g

ro
up

s.
B

M
C

M
ed

ic
a
l

R
es

ea
rc

h
M

et
h
o
d
o
lo

g
y,

6
, 3

5.
h

tt
ps

:/
/

w
w

w
.n

cb
i.

nl
m

.n
ih

.g
ov

/p
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c/
ar

ti
cl

es
/P

M
C

15
59

63
7/

pd
f/

14
71

-2
28

8-
6-

35
.p

df
.

E
co

lo
gi

ca
l

tr
ia

n
gu

la
ti

on

B
an

ni
ng

, J
. (

20
13

).
E

co
lo

g
ic

a
l

tr
ia

n
g
u
la

ti
o
n
:

A
n
a

p
p
ro

a
ch

fo

r
q
u
a
li

ta
ti

ve
m

et
a
-s

yn
th

es
is

. W
as

hi
ng

to
n,

D
C

:
U

S

D
ep

ar
tm

en
t

of
E

du
ca

ti
on

.

F
ra

m
ew

or
k

s
yn

th
es

is

B
ru

nt
on

, G
.,

O
li

ve
r,

S
.,

O
li

ve
r,

K
. (

20
06

).
A

s
yn

th
es

is
o

f
re

se
ar

ch
a

dd
re

ss
in

g
ch

il
dr

en
’s

, y
ou

ng
p

eo
pl

e’
s

an
d

pa
re

nt
s’

v
ie

w
s

of
w

al
ki

ng
a

nd
c

yc
li

ng
f

or
t

ra
ns

po
rt

.
L

on
do

n:
E

P
P

I-
C

en
tr

e.

G
ro

u
n

d
ed

f
or

m
al

th

eo
ry

E

av
es

, Y
. (

20
01

).
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s
yn

th
es

is
t

ec
hn

iq
ue

f
or

g
ro

un
de

d
th

eo
ry

d
at

a
an

al
ys

is
. J

o
u
rn

a
l

o
f

A
d
va

n
ce

d
N

u
rs

in
g,

3
5
,

65
4–

66
3.

M
et

a-
ag

gr
eg

at
io

n

H
an

ne
s,

K
.,

&
L

oc
kw

oo
d,

C
. (

20
11

).
P

ra
gm

at
is

m
a

s
th

e

SUPPLEMENT B TO CHAPTER 30 Supplementary Resources for Qualitative Evidence Syntheses � 30-5

(C
o
n
ti

n
u
ed

)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1559637/pdf/1471-2288-6-35.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1559637/pdf/1471-2288-6-35.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1559637/pdf/1471-2288-6-35.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618126/pdf/1471-2288-13-37.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618126/pdf/1471-2288-13-37.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3618126/pdf/1471-2288-13-37.pdf

https://reviewersmanual.joannabriggs.org/

https://reviewersmanual.joannabriggs.org

https://ncbi.nlm.nih.gov/pmc/articles/PMC3618126/pdf/1471

https://www

30-6 � PART 6 Building an Evidence Base for Nursing Practice

T
A

B
L

E
2

M
a

jo
r

R
e

fe
re

n
ce

(s
)

fo
r

E
a

ch
Q

u
a

li
ta

ti
v

e
E

v
id

e
n

ce
S

y
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th
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s

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p

p
ro

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ch

in
T

a
b

le
1

(C

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n

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e

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)

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et

a-
et

h
n

og
ra

p
h

y
C

am
pb

el
l,

R
.,

P
ou

nd
, P

.,
M

or
ga

n,
M

.,
D

ak
er

-W
hi

te
, G

.,
B

ri
tt

en
, N

.,
P

il
l,

R
.,


D

on
ov

an
, J

. (
20

11
).

E
va

lu
at

in
g

m
et

a-
et

hn
og

ra
ph

y:
S

ys
te

m
at

ic
a

na
ly

si
s

an
d

sy
nt

he
si

s
of

q
ua

li
ta

ti
ve

r
es

ea
rc

h.
H

ea
lt

h
T

ec
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en
t,

1
5

, 1
–1

64
. h

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ps

:/
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ry

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ac

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54
30

/#
/a

bs
tr

ac
t.

N
ob

li
t,

G
.,

&
H

ar
e,

R
. D

. (
19

88
).

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et

a
-e

th
n
og

ra
p
h
y:

S
yn

th
es

iz
in

g
q

u
a
li

ta
ti

ve
s

tu
d
ie

s.
N

ew
bu

ry
P

ar
k,

C
A

:
S

ag
e.

M
et

a-
in

te
rp

re
ta

ti
on

W

ee
d,

M
. (

20
05

).

M
et

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in

te
rp

re
ta

ti
on

”:
A

m
et

ho
d

fo
r

th
e

in
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re

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s
yn

th
es

is
o

f
qu

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it

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se
ar

ch
.

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o
ru

m
:

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u
a
li

ta
ti

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a
l

R
es

ea
rc

h
,
6
, 1

. h
tt

p:
//

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w

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.q

ua
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/5

08
/1

09
7

M
et

an
ar

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ti

ve

re
vi

ew

G
re

en
ha

lg
h,

T
.,

&
W

on
g,

G
. (

20
14

).
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ra
in

in
g
m

a
te

ri
a
ls

fo

r
m

et
a
-n

a
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a
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s.

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va

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f

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tt

p:
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.

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m

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oj

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t.

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g/

m
ed

ia
/M

et
a_

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at
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e_
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ew

s_
tr

ai
ni

ng
_m

at
er

ia
ls

.p
df

.

G
re

en
ha

lg
h,

T
.,

R
ob

er
t,

G
.,

M
ac

fa
rl

an
e,

F
.,

B
at

e,
P

,
K

yr
ia

ki
do

u,
O

.,
&

P
ea

co
ck

, R
. (

20
05

).
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to
ry

li
ne

s
of

re

se
ar

ch
i

n
di

ff
us

io
n

of
i

nn
ov

at
io

n:
A

m
et

a-
na

rr
at

iv
e

ap
pr

oa
ch

t
o

sy
st

em
at

ic
r

ev
ie

w
. S

o
ci

a
l

S
ci

en
ce

&
M

ed
ic

in
e,

6
1
, 4

17
–4

30
.

M
et

as
tu

d
y

P
at

er
so

n,
B

. L
.,

T
ho

rn
e,

S
. E

.,
C

an
am

, C
.,

&
J

il
li

ng
s,

C
.

(2
00

1)
. M

et
a
-s

tu
d
y

o
f

q
u
a
li

ta
ti

ve
h

ea
lt

h
r

es
ea

rc
h
.

T
ho

us
an

d
O

ak
s,

C
A

:
S

ag
e.

P
at

er
so

n,
B

. (
20

13
).

M
et

as
yn

th
es

is
. I

n
C

. T
. B

ec
k

(E
d.

).

R
o
u
tl

ed
ge

i
n
te

rn
a
ti

o
n
a
l

h
a
n
d
b
o
o
k

o
f

q
u
a
li

ta
ti

ve

n
u
rs

in
g
r

es
ea

rc
h
(

pp
. 3

31
–3

46
).

N
ew

Y
or

k:
R

ou
tl

ed
ge

.

M
et

as
u

m
m

ar
y

S
an

de
lo

w
sk

i,
M

.,
B

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. (
20

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).

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, J
. (

20
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).
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https://www.journalslibrary.nihr.ac.uk/hta/hta15430/#/abstract

https://www.journalslibrary.nihr.ac.uk/hta/hta15430/#/abstract

http://www.qualitative-research.net/index.php/fqs/article/view/508/1097

http://www.qualitative-research.net/index.php/fqs/article/view/508/1097

http://www.qualitative-research.net/index.php/fqs/article/view/508/1097

http://www.ramesesproject.org/media/Meta_narrative_reviews_training_materials.pdf

http://www.ramesesproject.org/media/Meta_narrative_reviews_training_materials.pdf

http://www.ramesesproject.org/media/Meta_narrative_reviews_training_materials.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2329806/pdf/nihms45489.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2329806/pdf/nihms45489.pdf

T
ho

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, M

.,
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t,
G

.,
&

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lo
w

sk
i,

M
. (

20
04

).
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ua
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:
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).
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, J
.,

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ob

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, M

.,
A

ra
i,

L
.,

R
od

ge
rs

, M
.,

&
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ri
tt

en
, N

. (
20

06
).

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u
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em
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s

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T

ho
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as
, J

.,
&

H
ar

de
n,

A
. (

20
08

).
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SUPPLEMENT B TO CHAPTER 30 Supplementary Resources for Qualitative Evidence Syntheses � 30-7

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.178.3100&rep=rep1&type=pdf

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.178.3100&rep=rep1&type=pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2478656/pdf/1471-2288-8-45.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2478656/pdf/1471-2288-8-45.pdf

30-8 � PART 6 Building an Evidence Base for Nursing Practice

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IN SUPPLEMENT B TO
CHAPTER 30

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*Booth, A., Noyes, J., Flemming, K., Gerhardus, A., Wahlster,
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*A link to this open-access article is provided in the
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http://www.integrate-hta.eu/downloads/

Publication Bias in Systematic Reviews
Reducing the Risk of Publication Bias
Detection of …

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