6-7-2016 Mixed studies review (MSR): An introduction P ROF . DR . A NN V AN H ECKE EANS Summer School 2017 Halle, Germany MEDICAL RESEARCH COUNCIL FRAMEWORK 2 1
6-7-2016 What do you think of results of systematic reviews? 3 "mixed studies review“ [Title/Abstract] OR "realist review“ • [Title/abstract] OR "mixed research synthesis“ [Title/abstract] OR "mixed methods review“ [Title/abstract] OR "mixed methods synthesis“ [Title/abstract] � n = 168 60 Number of publications 50 40 30 20 10 0 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 4 2
6-7-2016 MIXED STUDIES REVIEW Take 5 minutes to discuss in your group What do you think a Mixed studies review is? • Be prepared to answer the questions and argue in the larger group 5 MIXED STUDIES REVIEW: WHAT? Meta-Needs assessment (Gaber, 2000) • Mixed methods review or synthesis (Harden and Thomas 2005) • Realist review (Pawson et al. 2005) • Mixed research synthesis (Sandelowski, 2006) • Mixed approaches to evidence synthesis (Pope et al. 2007) • Mixed studies review (Pluye et al. 2009) • Mixed methods systematic review (Harden 2010) • Systematic mixed studies review (Polit & Beck 2012) • 6 3
6-7-2016 MIXED STUDIES REVIEW: WHAT? “A form of literature review in which a reviewer or reviewer team concomitantly reviews qualitative and quantitative studies, and / or mixed methods studies, for the broad purpose of breadth and depth of understanding and corroboration of knowledge based on all types of empirical research, and synthesizes qualitative findings and quantitative results of primary studies.” (Pluye et al. 2009) 7 MIXED STUDIES REVIEW: WHY? “What works under which circumstances” – More complete • understanding of a problem To provide illustrations of context for effect measures, • expecially in case of heterogeneity in effect reviews “Rarely do decision makers have just one question to • answer, they are more likely to have a series of questions” (Harden 2009) 8 4
6-7-2016 MIXED STUDIES REVIEW: WHY? Likely to generate more meaningful and useful findings for • patients, policy makers and healthcare professionals of the usefulness of the intervention Mixed studie reviews… “broaden the conceptualisation of evidence, are more • methodologically inclusive and produce syntheses of evidence that will be accessible to and usable by a wider range of consumers” (Sandelowski et al. 2012) 9 MIXED STUDIES REVIEW: WHEN? One particular synthesis approach, by itself, is inadequate to • develop a complete understanding Qualitative insights can help to explain or elaborate on • quantitative findings Quantitative review evidence can further generalize, test or • confim qualitative findings (Hannes 2015) 10 5
6-7-2016 MIXED STUDIES REVIEW: WHEN? Should pose a question that requires the inclusion of two or • more syntheses that are grounded in different approaches The questions may focus on: The effect of an intervention • The cost benefits of the intervention • The experiences of people with this intervention • 11 MIXED STUDIES REVIEW: HOW? 12 6
6-7-2016 MIXED STUDIES REVIEW Take 5 minutes to discuss in your group How would you perform a mixed methods review? • Be prepared to answer the questions and argue in the larger group 13 MIXED STUDIES REVIEW 14 7
6-7-2016 MIXED STUDIES REVIEW: TYPOLOGY Realist Synthesis (Pawson 2002) • = a theory-driven approach = “what works for whom in what circumstances” Example: Greenhalgh et al. (2007). Realist review to understand the efficacy of school feeding programmes. BMJ, 335, 858-861. Frameworks posited by Sandelowski et al. 2006) • • Segregated methodologies • Integrated methodologies • Contingent methodologies Framework posited by Johanna Briggs Institute 2014 • 15 MIXED STUDIES REVIEW: TYPOLOGY Segregated type of MSR Two separate syntheses of research addressing (sometimes • different but) connecting questions are integrated by a mixed method synthesis Confirmation / refutation or complementary • Especially useful in integrating information about both • effectiveness and context in programmatic intervention research 16 8
6-7-2016 MIXED STUDIES REVIEW: TYPOLOGY Segregated type 17 MIXED STUDIES REVIEW: TYPOLOGY Segregated type of MSR: example described in Harden 2010 Central questions: What is known about the barriers to and facilitators of healthy • eating among children? Do interventions promote healthy eating among children? • What are children’s own perspectives on health eating? • What are the implications for intervention development? • 18 9
6-7-2016 MIXED STUDIES REVIEW: TYPOLOGY Segregated type of MSR: an example Thematic analysis: e.g. Statistical meta-analysis / Children consider taste, forest plot: not health, to be a key Large variation in study influence on their food findings: Why? choice Recommendations for interventions that reflected children’s views 19 MIXED STUDIES REVIEW: TYPOLOGY Integrative type of MSR Studies viewed as answering the same research questions are • grouped by findings and not by design (method) Appropriate when textual + numerical findings are perceived as • able to confirm or refute each other Analysis include transformation / configuration of data to create • quantitative and qualitative data that are similar enough to be combined in a single synthesis 20 10
6-7-2016 MIXED STUDIES REVIEW: TYPOLOGY Integrative type of MSR Analysis include transformation / configuration of data to create • quantitative and qualitative data that are similar enough to be combined in a single synthesis: � Quantitative data converted to themes � Qualitative data converted to numerical format Example of integrative type of MSR: Voils et al. (2009). A Bayesian method for the synthesis of evidence from qualitative and quantitative reports: the example of antiretroviral medication adherence. J Health Serv Res Policy. 14(4):226-33. 21 MIXED STUDIES REVIEW: TYPOLOGY Integrated type 22 11
6-7-2016 MIXED STUDIES REVIEW: TYPOLOGY Contingent type of MSR A coordinated and sequential series of synthesis, can be • integrated and/or segregated in nature i.e. findings from one synthesis to address the research question • is used to address a second question – which may lead to another synthesis addressing a different research question 23 MIXED STUDIES REVIEW: TYPOLOGY Contingent type 24 12
6-7-2016 MIXED STUDIES REVIEW: TYPOLOGY Realist Synthesis (Pawson 2002) • = a theory-driven approach = “what works for whom in what circumstances” Frameworks posited by Sandelowski et al. 2006) • • Segregated methodologies • Integrated methodologies • Contingent methodologies Framework posited by Johanna Briggs Institute 2014 • 25 MIXED STUDIES REVIEW: TYPOLOGY JBI type 26 13
6-7-2016 MIXED STUDIES REVIEW Take 5 minutes – discuss in your group What are the (methodological) challenges when performing a • mixed methods review? Be prepared to answer the questions and argue in the larger group 27 MIXED STUDIES REVIEW: QUALITY? Garbage in, garbage out! 28 14
6-7-2016 MIXED STUDIES REVIEW: QUALITY? What is the minimum set of criteria for appraising the methodological quality of the qualitative, quantitative and mixed methods studies in a mixed studies review? Tool example: Mixed Method Appraisal Tool (Pace et al. 2012) 29 30 15
6-7-2016 STRENGHT AND CHALLENGES Words, pictures, narrative add meaning to numbers • Numbers add precision to words, pictures and narratives • Can provide stronger evidence for conclusion • Can increase insights and understanding • Reporting how the expertise of reviewers matched the • reviewed studies, while quality appraisal depends on revierwer expertise Need for mixed competences in research approach in the • research team Comprehensive MSR require resources • Infancy – confusion ahead • 31 FURTHER READINGS MIXED STUDIES REVIEW Hannes (2015). Building a case for mixed-methods review. In. Complex interventions in • health. An overview of research methods. Eds. Richards and Hallberg. Routledge London. Harden et al. (2005). Methodological issues in combining diverse study types in • systematic reviews. Int. J. Social Research Methodology, 8, 257-271. Johanna Briggs Institute Reviewers’ Manual 2014 edition. Australia. • Pace et al. (2012). Testing the reliability and efficiency of the pilot Mixed methods • appraisal tool (MMAT) for systematic mixed studies review. IJNS, 49, 47-53. Pluye et al. (2009). A scoring system for appraising mixed methods research, and • concomitantly appraising qualitative, quantitative and mixed methods primary studies in Mixed studies review. IJNS, 46, 529-546. Sandelowski et al. (2006). Defining and designing Mixed research synthesis studies. Res • Sch, 13, 29. Sandelowski et al. (2013). Tekst-in-context: a method for extracting findings in mixed- • methods mixed research synthesis studies. JAN, 69, 1428-1437. 32 16
Recommend
More recommend
