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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 SynthesisStepsTools/Software Used
Choosing a synthesis approach1. Select a qualitative synthesis approach appropriate for review questionRETREAT framework [19]: consider Review question, Epistemology, Timeframe, Resources, Expertise, Audience & purpose, and Type of data
Phase 1: Getting started1. Preliminary literature searchesDatabases (Embase, Scopus, PsycINFO)
2. Register review protocolPROSPERO (CRD42017055943)
Phase 2: Deciding what is relevant to the initial interest1. Develop search strategy and run exhaustive search of databasesDatabases searched: Cinahl Plus, Embase, Scopus, PsycINFO, Proquest (ASSIA and Sociological Abstracts)
2. Title and abstract screeningCOVIDENCE
3. Full text screeningMicrosoft Word
4. Team discussions about discrepancies 
5. Supplementary searchesReference lists, author searches on Google Scholar, ‘Cited by’ tools on Scopus and Google Scholar
Phase 3: Reading the studies1. Data extraction (full texts)NVivo
2. Noting initial observationsMemos in NVivo
3. Extract key contextual information and key findingsNVivo (to organise data)
Microsoft Word (to visualise data in table format)
4. Quality appraisalJoanna Briggs Institute Critical Appraisal Checklist [28]
Phase 4: Determining how the studies are related1. Consider similarities and differences across studiesMatrix in NVivo
Table in Microsoft Word
Phase 5: Translating the studies into one another1. 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 studiesMicrosoft Excel spreadsheet
4. Colour coding 1st order (participant quotes), 2nd order (primary study author) and 3rd order (reviewer) interpretations to preserve context and meaningMicrosoft Excel spreadsheet
Phase 6: Synthesising translations1. 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 studiesMicrosoft 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 themMicrosoft Word
5. Map relationships between key themes within each individual studyConceptual models using paper and pen
6. Integrate individual conceptual models to form an overarching conceptual model of relationships between constructs across studiesConceptual model (Microsoft PowerPoint) (See Fig. 2)
Phase 7: Expressing the synthesis1. Write a summary of each theme supported by quotesMicrosoft Word
2. Illustrate findings visuallyConceptual 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 findingsGRADE CERQual [30]
5. Consider quality of reportingENTREQ [25] QMARS [20] eMERGe [31]
6. Rewrite theme summaries considering confidence and alternative interpretationsMicrosoft Word