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Table 1 Questions to guide whether, when and how to update a meta-ethnography

From: Why, when and how to update a meta-ethnography qualitative synthesis

Guiding questions

Issues to consider

This is a consideration in deciding

Whether to update

When to update

How to update

Q1. What was the aim of the original meta-ethnography (and is it time-sensitive)?

If data are out-of-date, then an update might be needed. If the aim was tied to a specific time period in the past, the original findings may not be relevant to current practice. The aim may have implications for how to update, given the original search strategy.


Q2. What is the aim of the updated meta-ethnography?

The original and updated search strategies must be compatible with the update aim.


Q3. What is the publication rate of relevant new studies?

A high volume of publications could warrant an update and influence how the update is done (see also Q6).

Q4. What is the quality of the (conduct and reporting) of the original meta-ethnography?

If it is low quality:

• an update could increase the trustworthiness and hence utility of the findings

• the value of adding to or comparing with the original findings is questionable

• in terms of timing it could be re-done immediately.

Q5. Have there been methodological advances in qualitative reviewing and/or the meta-ethnography approach?

If yes, an update could increase the trustworthiness and hence utility of the findings. In terms of timing, it could be re-done immediately (see also Q6).

Q6. Was conceptual saturation achieved in the original meta-ethnography?

If yes, inclusion of further relevant studies is unlikely to add insights unless they contain new data on experiences (see Q7).


Q7. Are there (publications on) new patient populations, health care contexts, treatments and/or interventions since the original meta-ethnography?

If yes, an update could be useful because people’s experiences might differ from those already reported. Could require a revised review question and literature search strategy.

Q8. Does the review question need to be revised?

If answer to Q7 is “yes”, then it may be necessary to revise the review question, literature search strategy and inclusion criteria, e.g. to include a new patient population.


Q9. What are the potential consequences of not updating the original meta-ethnography?

If findings are out-of-date but being applied in current policy/practice, the findings may not be useful or may even be harmful.