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Table 3 Tools of likely use for elements 2 through 4 of the narrative synthesis[24, 32]

From: Immigrant women’s experiences of postpartum depression in Canada: a protocol for systematic review using a narrative synthesis

Element 2. Preliminary synthesis of findings
1. Textual description of the studies A descriptive paragraph with headings Setting, Participants, Aim, Sampling and Recruitment, Method, Analysis, Results, ‘Thick’ or ‘Thin’ study. This may be represented in tabular format.
2. Groupings 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. Groupings may be by a particular feature, for example, location, method, ethnic groups, form of analysis or main findings.
3. Translating data: thematic analysis To identify main or recurrent themes in findings.
Element 3. Exploring relationships within and between studies
1. Moderator variables and subgroup analysis Identifying study characteristics that vary between studies or sample (subgroup) characteristics which might help explain differences in findings.
2. Ideas webbing and concept mapping Ideas webbing conceptualizes and explores connections among 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.
3. 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
1. Critical reflection Summary discussion with the topics of: a) methodology of the synthesis (focusing on the limitations and their possible impact on the results); b) evidence used (quality, reliability, validity and generalizability); c) assumptions made; d) discrepancies and uncertainties identified and how discrepancies were dealt with; e) areas where the evidence is weak or non-existent; f) possible areas for future research and, finally; g) a discussion of the evidence presented that will consider the ‘thick’ and ‘thin’ evidence and comment on similarities and/or differences between evidence.