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Table 1 Principles of meta-narrative review with application examples

From: Clearing the air: protocol for a systematic meta-narrative review on the harms and benefits of e-cigarettes and vapour devices

Principle Definition Application in Clearing the Air review
Pragmatism The reviewer is guided by the needs of the intended audience and by what is most likely to promote sense making. Knowledge user partners approached the research team with questions about the available evidence on vapour devices, initiating the study. They were actively involved in defining the research questions, and will be involved throughout the process as the results emerge. The pragmatic need to answer these questions will include careful attention to evaluating the evidence, within the larger methodological goal of constructing overarching narratives and addressing the conflicts.
Pluralism The topic is explored from multiple perspectives and the quality of the research or evidence is judged by criteria intrinsic to the research tradition from which it emerged. The aim is “to expose the tensions, map the diversity and communicate the complexity of how the different traditions contribute to understanding of the problem” ([32], p. 427) Preliminary mapping suggested several research traditions each taking a different focus on the topic. Strong contestation is occurring within and between traditions on the harms and benefits of vapour devices. Team members come from different disciplinary backgrounds bringing different paradigmatic lenses to understanding the evidence. Use of evaluation criteria specific to each paradigm contributes to a pluralistic view of the evidence.
Historicity The review explores the various research traditions as they unfold over time, including major events, key scientists, and discoveries that have shaped the tradition. The result is an emerging storyline that is not so much a “unified voice” but the unfolding of current agreements and disagreements. The emergence of key claims and counter claims about vapour devices within specific traditions and the evidence to support those claims is being explored. Key reviews, editorials, and news items that have fueled the debate about vapour devices are being explored. This helps to contextualize how the evidence itself is understood, interpreted, and taken up within distinct traditions.
Contestation The conflicting data from within and between research traditions are analyzed. Meta-narrative reviewers “explicitly seek to expose and unpack the ‘incommensurabilities’ that underpin conflicting data.” ([32], p. 428) In the search and selection phase of the review, contestation was explicitly sought, with conflicting evidence and perspectives retained for review. In the synthesis phase, the goal is to find epistemological, pragmatic explanations for conflicting findings or recommendations.
Reflexivity The reviewers must continually reflect, individually and as a team, on the emerging findings throughout the review. We aim to cultivate in our team a spirit of critical reflexivity in which we challenge our own and each other’s assumptions and interpretations. The diversity in the team members’ backgrounds should help to promote reflection and cross-disciplinary analysis.
Peer review The emerging findings are tested by presenting them to external reviewers in a formative way, and this feedback informs subsequent reflection and analysis We met with our knowledge user partners to report search and preliminary mapping progress and obtained their feedback. Potential value conflicts driving the debate is providing guidance for reflection and further analysis as the review progresses. At various points in the process, knowledge users will take the findings to colleagues in their organizations to discuss and obtain feedback.
  1. Drawn from Greenhalgh et al. [32], Greenhalgh and Wong [37], and Greenhalgh et al. [34]