Testing Methodological Guidance on the Conduct of Narrative Synthesis in Systematic Reviews

Abstract

The objective was to assess the impact of new guidance on the conduct of narrative synthesis in systematic reviews of effectiveness, by means of a blinded comparison of guidance-led narrative synthesis against a meta-analysis of the same study data.The conclusions of the two syntheses were broadly similar. However, differences between the approaches meant that conclusions about the impact of moderators of effect appeared stronger when derived from the meta-analysis, whereas implications for future research appeared more extensive when derived from the narrative synthesis. These findings emphasize that a rigorously conducted narrative synthesis can add meaning and value to the findings of meta-analysis.The guidance framework provided a useful vehicle for structuring a narrative synthesis and increasing transparency and rigour of the process.While there may be risks with overinterpretation of study data, the framework, tools and techniques described in the guidance appear to increase the transparency and reproducibility of narrative synthesis.

Selection, Use and Psychometric Properties of Physical Activity Measures to Assess Individuals with Severe Mental Illness: A Narrative Synthesis

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Mining the Management Literature for Insights into Implementing Evidence-Based Change in Healthcare

“…The broad scope of the review and diverse forms of evidence within it pointed to a systematic approach known as narrative synthesis as the prime method for integrating and describing preliminary findings. Narrative syntheses use words and text to distill data and explain relationships, and are a valid means of building a body of aggregated knowledge while recognizing barriers and facilitators to implementation (Arai et al 2007;mays et al 2005;Rodgers et al 2009). A flow chart summarizing the overall review and synthesis process is presented in figure 1.…”

“…Our synthesis process of handsearching each issue over the sampling period, abstracting data from each study, confirming the accuracy of abstractions with authors, and preparing the database is labour intensive and Karen Harlos et al costly. Narrative syntheses may also run the risk of over-interpretation of study data (Rodgers et al 2009). We applied several safeguards to mitigate this risk, such as pre-specified inclusion criteria, a clearly defined process of synthesis, checks with authors to verify data accuracy, and checks with second researchers in iterative, critical appraisals until consensus was reached.…”

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