How to locate and appraise qualitative research in complementary and alternative medicine

Abstract

BackgroundThe aim of this publication is to present a case study of how to locate and appraise qualitative studies for the conduct of a meta-ethnography in the field of complementary and alternative medicine (CAM). CAM is commonly associated with individualized medicine. However, one established scientific approach to the individual, qualitative research, thus far has been explicitly used very rarely. This article demonstrates a case example of how qualitative research in the field of CAM studies was identified and critically appraised.MethodsSeveral search terms and techniques were tested for the identification and appraisal of qualitative CAM research in the conduct of a meta-ethnography. Sixty-seven electronic databases were searched for the identification of qualitative CAM trials, including CAM databases, nursing, nutrition, psychological, social, medical databases, the Cochrane Library and DIMDI.Results9578 citations were screened, 223 articles met the pre-specified inclusion criteria, 63 full text publications were reviewed, 38 articles were appraised qualitatively and 30 articles were included. The search began with PubMed, yielding 87% of the included publications of all databases with few additional relevant findings in the specific databases. CINHAL and DIMDI also revealed a high number of precise hits. Although CAMbase and CAM-QUEST® focus on CAM research only, almost no hits of qualitative trials were found there. Searching with broad text terms was the most effective search strategy in all databases.ConclusionsThis publication presents a case study on how to locate and appraise qualitative studies in the field of CAM. The example shows that the literature search for qualitative studies in the field of CAM is most effective when the search is begun in PubMed followed by CINHAL or DIMDI using broad text terms. Exclusive CAM databases delivered no additional findings to locate qualitative CAM studies.

Quality assessment of qualitative evidence for systematic review and synthesis: Is it meaningful, and if so, how should it be performed?

“…The superfluity of inadequate studies was echoed in the analysis by Franzel et al . (), who found that, “The themes from the excluded papers would not have altered the meta‐synthesis. Theoretical study saturation was achieved because no new relevant data emerged regarding a category, either to extend or to contradict it.” Tong et al .…”

“…For example, Franzel et al . () excluded any study that failed to satisfy all of their criteria; Carroll et al . () excluded those studies that satisfied only one of four criteria; Toye et al .…”

“…Franzel et al . () “excluded” studies based on a combination of reporting and more subjective elements. The post hoc “exclusion” of studies' findings from the synthesis was made possible because both reviews performed a type of thematic synthesis, so the supporting studies and evidence for each theme or sub‐theme were recorded.…”

“…() applied quality of reporting criteria only, while Franzel et al . () considered criteria relating to the plausibility and coherence of results and reflexivity, as well as reporting. One strength of sensitivity analysis is that the critical appraisal criteria and the quality “threshold” must be specified but need not be standardised.…”

“…As with critical appraisal generally, a degree of agreement exists: The threshold being applied is often reported by reviewers, but otherwise, there is no standardisation. For example, Franzel et al (2013) excluded any study that failed to satisfy all of their criteria; Carroll et al (2012) excluded those studies that satisfied only one of four criteria; Toye et al (2013) "excluded studies from our meta-ethnography on the basis that the methodological report was insufficient to make a judgment on interpretive rigour…(by consensus on intuitive criteria)." Such divergence is not new.…”