Cochrane Qualitative and Implementation Methods Group guidance series—paper 2: methods for question formulation, searching, and protocol development for qualitative evidence synthesis

Abstract

This paper updates previous Cochrane guidance on question formulation,searching and protocol development, reflecting recent developments in methods for conducting qualitative evidence syntheses to inform Cochrane intervention reviews. Examples are used to illustrate how decisions about boundaries for a review are formed via an iterative process of constructing lines of inquiry, and mapping the information available to ascertain whether evidence exists to answer questions related to effectiveness, implementation, feasibility, appropriateness, economic evidence, and equity. The process of question formulation allows reviewers to situate the topic in relation to how it informs and explains effectiveness, using the criterion of meaningfulness, appropriateness, feasibility and implementation. Questions related to complex questions and interventions can be structured by drawing on an increasingly wide range of question frameworks. Logic models and theoretical frameworks are useful tools for conceptually mapping the literature to illustrate the complexity of the phenomenon of interest. Further, protocol development may require iterative question formulation and searching. Consequently, the final protocol may function as a guide rather than a prescriptive route-map, particularly in qualitative reviews that ask more exploratory and open ended questions.Keywords: Systematic reviews, question formulation, Cochrane Collaboration, methods, qualitative evidence synthesis. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Word count: 4014 words excluding tables and references Key findings:Tools and methods are recommended to assist reviewers in developing protocols, which accommodate alternative approaches to question formulation and searching and protocol development for qualitative evidence synthesis. What this adds to what was known?Questions within qualitative and implementation systematic review protocols may be indicative, allowing more detailed questions to be formulated when more information is needed on specific aspects of the review. A broader range of question formats is presented, to reflect the need for reviews that explore and generate theory. What is the implication and what should change now?This guidance provides examples of protocols for qualitative evidence synthesis that are flexible, to allow the incorporation of open-ended and exploratory review questions and iterative searching methods. 'recontextualise' effectiveness. Recontextualising requires considering effectiveness research in relation to issues in society [4] to enable a decision-maker to make an informed decision about whether an intervention is likely to be useful and whether that intervention is applicable to their local population. Qualitative research produces contingent and experiential knowledge on why interventions work the way that they do (or fail to work) [5]. Further, implementation questions provide information on how the implementation process produces...

The lived experience of working with people with eating disorders: A meta‐ethnography

“…Seven articles that were not identified by the previous search were deemed suitable for full screening; none of these met the inclusion criteria. Difficulty with locating qualitative papers through traditional databases (Booth, ), due to issues with MESH terms and filters, has led to a suggestion that other means of accessing them (e.g., hand searching and citation tracking) should be employed (Harris et al, ). Reviewers have been warned to extend searches beyond well‐known databases to avoid missing journals with relevant information that are not referenced on them (Booth, ).…”

“…searching and citation tracking) should be employed (Harris et al, 2018). Reviewers have been warned to extend searches beyond wellknown databases to avoid missing journals with relevant information that are not referenced on them (Booth, 2016).…”

The research burden of randomized controlled trial participation: a systematic thematic synthesis of qualitative evidence

“…We performed a systematic review and synthesis of qualitative research. We used thematic synthesis methods outlined by Thomas and Harden [8] and guidelines from the Cochrane Qualitative Methods Group [9]. We used an interpretative approach to go beyond the content of the original studies to develop analytical themes encompassing research burden.…”

Qualitative evidence syntheses: Assessing the relative contributions of multi‐context and single‐context reviews

“…Single‐context QESs need to identify as rich a dataset as resources allow (depth) e.g., local and regional journals, theses from institutional repositories, unpublished process evaluations etcetera. Specifying a context‐specific review question (e.g., geographical limits) typically influences selection of appropriate sources (Harris et al, ; Stansfield, Kavanagh, Rees, Gomersall, & Thomas, ). Hannes and Harden () characterize the data required for a single‐context review as follows:

“… the use of a selective search with a focus on studies (both published and unpubl.)

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“…If, however, the emphasis is on the shared experience of the women and the psychological effects of the procedure then this may justify a multi‐context QES. Definitions of what constitutes ‘relevant context’ are contested and review‐specific and should be informed by the ‘ambition’ or ‘sphere of influence’ of each individual review (Harris et al, ).…”