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Table 2 Tools of possible value for elements 2 to 4 of the narrative synthesis[46, 52]

From: Immigrant women’s experiences of maternity-care services in Canada: a protocol for systematic review using a narrative synthesis

  Tasks Explanation
Element 2: preliminary synthesis of findings Textual description of the studies A descriptive paragraph with headings of ‘Setting’, ‘Participants’, ‘Aim’, ‘ Sampling and recruitment’, ‘Method’, ‘Analysis’, ‘Results’, and ‘thick’ or ‘thin’ study. This may be represented in tabular format
Grouping and clustering of studies The data extracted for the textual description will allow papers to be grouped and thus enable patterns between and within studies to be identified. This will be informed by the research questions. Data may be grouped by a particular feature (for example, location, method, ethnic groups, form of analysis, or main findings)
Translating data: thematic analysis To identify main or recurrent themes in findings
Element 3: exploring relationships within and between studies Moderator variables and subgroup analysis Identifying study characteristics that vary between studies, or sample (subgroup) characteristics that might help explain differences in findings
Ideas webbing and concept mapping ‘Ideas webbing’ conceptualizes and explores connections between the findings reported in the review studies and often takes the form of a spider diagram. ‘Concept mapping’ links multiple pieces of information from individual studies, using diagrams and flow charts to construct a model with relevant key themes
Qualitative case descriptions Descriptions of outliers or exemplars of why particular results were found in the outcome studies
Element 4: assessing the robustness of the synthesis Weight of evidence or validity assessment To enable scoring of studies, quality checklists (to be determined still) will be used, and weighted scores will be applied after agreement of all researchers
  Critical reflection Summary discussion, covering: 1) the synthesis methodology (focusing on the limitations and their possible effect on the results); 2) evidence used (quality, reliability, validity, and generalizability); 3) assumptions made; 4) discrepancies and uncertainties identified, and how discrepancies were dealt with; 5) areas where the evidence is weak or nonexistent; 6) possible areas for future research; and 7) discussion of the evidence, considering the ‘thick’ and ‘thin’ evidence and commenting upon similarities and/or differences between the various sources of evidence
  1. CASP Critical Appraisal Skills Programme.