Developing a reporting guideline to improve meta-ethnography in health research: the eMERGe mixed-methods study

Abstract

BackgroundMeta-ethnography is a commonly used methodology for qualitative evidence synthesis. Research has identified that the quality of reporting of published meta-ethnographies is often poor and this has limited the utility of meta-ethnography findings to influence policy and practice.ObjectiveTo develop guidance to improve the completeness and clarity of meta-ethnography reporting.Methods/designThe meta-ethnography reporting guidance (eMERGe) study followed the recommended approach for developing health research reporting guidelines and used a systematic mixed-methods approach. It comprised (1) a methodological systematic review of guidance in the conduct and reporting of meta-ethnography; (2) a review and audit of published meta-ethnographies, along with interviews with meta-ethnography end-users, to identify good practice principles; (3) a consensus workshop and two eDelphi (Version 1, Duncan E, Swinger K, University of Stirling, Stirling, UK) studies to agree guidance content; and (4) the development of the guidance table and explanatory notes.ResultsResults from the methodological systematic review and the audit of published meta-ethnographies revealed that more guidance was required around the reporting of all phases of meta-ethnography conduct and, in particular, the synthesis phases 4–6 (relating studies, translating studies into one another and synthesising translations). Following the guidance development process, the eMERGe reporting guidance was produced, comprising 19 items grouped into the seven phases of meta-ethnography.LimitationsThe finalised guidance has not yet been evaluated in practice; therefore, it is not possible at this stage to comment on its utility. However, we look forward to evaluating its uptake and usability in the future.ConclusionsThe eMERGe reporting guidance has been developed following a rigorous process in line with guideline development recommendations. The guidance is intended to improve the clarity and completeness of reporting of meta-ethnographies, and to facilitate use of the findings within the guidance to inform the design and delivery of services and interventions in health, social care and other fields. The eMERGe project developed a range of training materials to support use of the guidance, which is freely available atwww.emergeproject.org(accessed 26 March 2018). Meta-ethnography is an evolving qualitative evidence synthesis methodology and future research should refine the guidance to accommodate future methodological developments. We will also investigate the impact of the eMERGe reporting guidance with a view to updating the guidance.Study registrationThis study is registered as PROSPERO CRD42015024709 for the stage 1 systematic review.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

Improving reporting of meta‐ethnography: The eMERGe reporting guidance

“…Members of the project advisory group and project team reviewed and agreed the final guidance table and explanatory notes. Supplementary File S1 gives details of the methods which also appear in a published protocol and funder's report …”

“…While the guidance was developed for meta‐ethnography, some of the reporting criteria, such as those relating to stating a review question and reporting literature search and selection strategies, might also be applicable to other forms of qualitative evidence synthesis and thus overlap with the generic ENTREQ guidance for reporting a wide range of qualitative evidence syntheses . In contrast to eMERGe, ENTREQ does not provide guidance regarding reporting of the complex analytic synthesis processes (Phases 4–6) in a meta‐ethnography and did not follow good practice guidance for developing a reporting guideline, for example, it was not designed with the consensus of a wider community of experts …”

“…in a meta-ethnography and did not follow good practice guidance for developing a reporting guideline, 31 for example, it was not designed with the consensus of a wider community of experts. 34,35 The eMERGe guidance consists of three parts: for format and content of the meta-ethnography output (for example, of an abstract); assessment of methodological strengths and limitations of included primary studies; and using the GRADE CERQual approach to assess confidence in findings from qualitative evidence syntheses. 1,26 Users of this guidance should note that meta-ethnography is an iterative process and although the guidance is presented by metaethnography phases, we are not advocating a linear approach to meta-ethnography conduct.…”

Improving reporting of meta‐ethnography: The eMERGe reporting guidance

“…Members of the project advisory group and project team reviewed and agreed the final guidance table and explanatory notes. Supplementary File S1 gives details of the methods which also appear in a published protocol (France et al, 2015) and funder's report (Cunningham et al, 2018).…”

A situated philosophical perspective would make some of the paradigm wars in qualitative evidence synthesis redundant: A commentary on Bergdahl’s critique of the meta‐aggregative approach

“…From that perspective, we welcome the critique of meta‐aggregation published in Nursing Inquiry as a contribution to science (Bergdahl, ). Some pertinent points were raised in this critique, as was one of the perennial challenges in any methodology, namely, that of facilitating increased consistency of reporting among qualitative evidence synthesis review authors (Cunningham et al, ). In considering the essence of Bergdahl's critique, we revisit the position from which the critique was raised and propose a more situated epistemological perspective towards what a qualitative evidence synthesis might look like.…”