How do you add up if there are no numbers: Qualitative Synthesis

Regular readers of this blog will know of its penchant for systematic review techniques (evidenced in the recent I-squared blog ). The process of qualitative synthesis uses many of those familiar methods – defining a clear question, systematic literature searching, selecting appropriate research and assessing the risk of bias. Following this, however, qualitative syntheses begin to look really quite different – mostly because there are no nice numbers to add up and give ‘the answer’ but also because they are just not written in language we understand (read the qualitative research blog series to help with this)!

So how on earth do we go about reading a qualitative synthesis and deciding whether its any good?

Well, instead of reinventing the wheel, we can just modify our FAST assessment:

F – Find all the studies?

As for a quantitative review – check they got everything you think might be relevant.
A – Appraise them right?

Again – did they look at the quality of the work they found and discuss how this might have impacted on their results.

S – Synthesis.

Did they clearly describe what they’ve done with the data they found? How did they pull the work together? Is there a clear path from the original papers to the overall conclusions? Do they give you quotes and examples to let you decide for yourself whether they did it right? Are they up-front about the influence of their own experiences and perceptions on the work?

T- Take home messages.

How does this research change you? Does it further your theoretical understanding of a concept or issue in your practice? Do you now think differently about the patients you meet or the services you work in? Is there a direct application – can you start to ask about certain issues or begin to tackle something consistently raised?


Hopefully, this will make reading qualitative syntheses less daunting and provide a positive way to tackle this new form of research.

– @drjessmorgan

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