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• W2982057058 abstract "We aim to address diversity of methodology as an attribute of qualitative evidence synthesis; this will, we believe, contextualise and more fully inform the position of the Joanna Briggs Institute (JBI) Qualitative Evidence Synthesis Methods Group in relation to meta-aggregation. Noblit and Hare's seminal work on the development of meta-ethnography was a major source of information for the critique (Noblit & Hare, 1988). As background, it should be noted that meta-ethnography was informed by a series of ethnographic studies investigating racial segregation in the US school system. The funders had requested a report that consolidated and brought together the key concepts and factors across the individual studies. Noblit and Hare were critical of their own method of synthesis and attributed the perceived failure of their cross-site aggregative analyses to two core factors: first, the synthesis had been conducted in the absence of an a priori interpretive sociological framework, and second, the research team lacked insight into the relationship between research and practice in the field of education (Noblit & Hare, 1983). Noblit and Hare had adopted Geertz's perspective that the purpose of interpretive explanation is theory building through thick descriptions, whereas in the social sciences, aggregation facilitates general conclusions (Shankman, 1984). This sociological perspective on theory building as the primary pursuit of knowledge synthesis requires caution when extrapolating to practising health professions whose primary interests are in the delivery of care. This is not to say that practising clinicians are atheoretical; rather, expert clinical practice is founded on theory and evidenced through ‘thinking in action’ (Benner, Kooper-Kyriakidis, & Stannard, 2011; Benner, Tanner, & Chesla, 2009; Schön, 1991). Noblit and Hare's guidance for meta-ethnography was embraced by social scientists and health science academics interested in constructivist ontological perspectives and is described by Bergdahl (2018) as analogous with meta-synthesis. We credit Bergdahl (2018) for the comment that the example review cited from Lamb and colleagues would have had different results if it were conducted from an interpretive perspective (Lamb, Buchanan, Godfrey, Harrison, & Oakley, 2008). We doubt, however, whether it should have had different results, taking into account that its primary goal was making a contribution to the practising professions, particularly clinicians who require practice-centric explanations to support evidence-based decision-making. To use one of the examples that Bergdahl cited, Lamb and colleagues conducted a systematic review of psychosocial spiritual experiences of elderly individuals recovering from cerebral vascular injury (Lamb et al., 2008). The four major synthesised findings were aggregated from the analytic data extracted from the 27 included studies, and while no mid-range theory was offered, that was not the goal of the method or the researchers. The claim that the endpoint of a qualitative evidence synthesis ends with a theory positions Bergdahl with the general belief that only one philosophical paradigm is appropriate for all types of qualitative syntheses. We differ from Bergdahl in that we believe different philosophical stances are applicable to different situations and review contexts. Meta-aggregation works well. Operating from a pragmatist perspective, we argue there is a role for inquiry in transforming or understanding clinical situations in which we are involved. The review authors’ intent in using meta-aggregation was to offer a new understanding for clinicians and academics alike who care for elderly patients recovering from stroke (Lamb et al., 2008). This perspective is aligned with pragmatism in which a researcher seeks clarity of meaning and considers the consequences of action (Cherryholmes, 1992). This is, of course, more likely when the findings are assumed to be well specified (Pearson, Wiechula, & Lockwood, 2007). Well-specified data that assist with auditability of the reviewers’ decisions in understanding the experiences of this patient population can offer new ways to assess, manage and evaluate patients and families on their own terms and are entirely aligned with qualitative research traditions. The critique provided by Bergdahl is overshadowed by a lack of clarity on the terms used across the qualitative synthesis community. The pooling or synthesis of qualitative findings is sometimes referred to as meta-synthesis. However, as others have noted, this label has been criticised on the grounds that it is not specific to qualitative research (Centre for Reviews & Dissemination, University of York, 2009) and also that it has been used to describe a specific methodology and as a generalised label for multiple qualitative synthesis methodologies (Edwards & Kaimal, 2016; Walsh & Downe, 2005). Meta-aggregation is one of many different methodologies that are more appropriately considered forms of ‘qualitative evidence synthesis’, as is meta-ethnography. Given this fact, it is unclear why Bergdahl has chosen to contrast meta-aggregation solely with meta-ethnography rather than considering its place within qualitative evidence synthesis more broadly. In the light of the uncertainty around language, using these terms to situate specific beliefs about scientific credibility could be considered a false flag. In the JBI approach to meta-aggregation, findings are grouped based on similarity of meaning (as Bergdahl rightly highlights) into categories, from which synthesised findings are constructed. Bergdahl takes issue with this concept of ‘similarity in meaning’; however, that phrase does not just mean simply matching like with like. Instead, the findings are addressing a similar phenomenon. The grouping of a series of findings facilitates the development of a category, which, as a statement, reflects the review team's perspective on what the combined meaning of the findings represents. In meta-aggregation, the operational definition of a category is a descriptive statement that meaningfully brings together key concepts arising from the aggregation of two or more like findings (Lockwood, Munn, & Porritt, 2015). Categories are accompanied by an explanatory statement that conveys the whole, inclusive meaning of a group of findings. It is clearly the intent in meta-aggregation that the reviewer's interpretive process during categorisation must be linked explicitly and directly to the actual findings. Therefore, while categorisation is an interpretive process, it is both guided and constrained by the evidence extracted from the papers, rather than left to the review authors’ interpretive perspective. Synthesising the categories into final synthesised statements that represent the overall meaning of the categories forms a summary of the evidence to guide clinicians and policy-makers and helps to inform practice. As such, the synthesised findings produced using meta-aggregative methods are practice-guiding statements grounded in the data. In conclusion, we emphasise that there is no singular methodology for qualitative evidence synthesis that will meet all the knowledge needs of the health sciences and practising professions. For particular types of knowledge needs, we argue that meta-aggregation based on synthesis of the best available evidence is robust and transparent and presents reliable and useful guidance to inform clinical decision-making." @default.
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• W2982057058 title "A situated philosophical perspective would make some of the paradigm wars in qualitative evidence synthesis redundant: A commentary on Bergdahl’s critique of the meta‐aggregative approach" @default.
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