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Table 1 Meta-ethnography phases, steps, and tools/software used to review and synthesise studies

From: Childhood fussy/picky eating behaviours: a systematic review and synthesis of qualitative studies

Phase of Review and Synthesis Steps Tools/Software Used
Choosing a synthesis approach 1. Select a qualitative synthesis approach appropriate for review question RETREAT framework [19]: consider Review question, Epistemology, Timeframe, Resources, Expertise, Audience & purpose, and Type of data
Phase 1: Getting started 1. Preliminary literature searches Databases (Embase, Scopus, PsycINFO)
2. Register review protocol PROSPERO (CRD42017055943)
Phase 2: Deciding what is relevant to the initial interest 1. Develop search strategy and run exhaustive search of databases Databases searched: Cinahl Plus, Embase, Scopus, PsycINFO, Proquest (ASSIA and Sociological Abstracts)
2. Title and abstract screening COVIDENCE
3. Full text screening Microsoft Word
4. Team discussions about discrepancies  
5. Supplementary searches Reference lists, author searches on Google Scholar, ‘Cited by’ tools on Scopus and Google Scholar
Phase 3: Reading the studies 1. Data extraction (full texts) NVivo
2. Noting initial observations Memos in NVivo
3. Extract key contextual information and key findings NVivo (to organise data)
Microsoft Word (to visualise data in table format)
4. Quality appraisal Joanna Briggs Institute Critical Appraisal Checklist [28]
Phase 4: Determining how the studies are related 1. Consider similarities and differences across studies Matrix in NVivo
Table in Microsoft Word
Phase 5: Translating the studies into one another 1. Enter key contextual information for each study to preserve context and meaning of original studies throughout the analysis process. Microsoft Excel spreadsheet
2. Enter metaphors (findings from each study) into table (row for each study, column for each new metaphor not already reported by a previous study)
If studies reported similar findings under different names or themes, these findings were entered into the same column and a metaphor name was selected which best represented all of the data
Microsoft Excel spreadsheet
3. Compare each study against all previous studies, observing initial similarities (reciprocal translations) and differences (refutational translations) between studies Microsoft Excel spreadsheet
4. Colour coding 1st order (participant quotes), 2nd order (primary study author) and 3rd order (reviewer) interpretations to preserve context and meaning Microsoft Excel spreadsheet
Phase 6: Synthesising translations 1. Read excel file row by row summarising similarities and differences of each study (reciprocal and refutational translations) Microsoft Excel spreadsheet
2. Read excel file column by column to define, refine and summarise each metaphor while observing similarities and differences across studies Microsoft Excel spreadsheet
3. Group similar metaphors (original findings) together into 3rd order constructs (categories developed by reviewer) Microsoft Word
4. Develop themes that describe constructs and relationships between them Microsoft Word
5. Map relationships between key themes within each individual study Conceptual models using paper and pen
6. Integrate individual conceptual models to form an overarching conceptual model of relationships between constructs across studies Conceptual model (Microsoft PowerPoint) (See Fig. 2)
Phase 7: Expressing the synthesis 1. Write a summary of each theme supported by quotes Microsoft Word
2. Illustrate findings visually Conceptual model (Microsoft PowerPoint)
3. Consider purpose and audience of review  
4. Assess confidence in review findings (relationships in the model), and consider any alternative interpretations of findings GRADE CERQual [30]
5. Consider quality of reporting ENTREQ [25] QMARS [20] eMERGe [31]
6. Rewrite theme summaries considering confidence and alternative interpretations Microsoft Word