Developing a reporting guideline to improve meta-ethnography in health research: the eMERGe mixed-methods study

Cunningham, Maggie; France, Emma F; Ring, Nicola; Uny, Isabelle; Duncan, Edward AS; Roberts, Rachel J; Jepson, Ruth G; Maxwell, Margaret; Turley, Ruth L; Noyes, Jane

Abstract

Background
Meta-ethnography is a commonly used methodology for qualitative evidence synthesis. Research has identified that the quality of reporting of published meta-ethnographies is often poor and this has limited the utility of meta-ethnography findings to influence policy and practice.

Objective
To develop guidance to improve the completeness and clarity of meta-ethnography reporting.

Methods/design
The meta-ethnography reporting guidance (eMERGe) study followed the recommended approach for developing health research reporting guidelines and used a systematic mixed-methods approach. It comprised (1) a methodological systematic review of guidance in the conduct and reporting of meta-ethnography; (2) a review and audit of published meta-ethnographies, along with interviews with meta-ethnography end-users, to identify good practice principles; (3) a consensus workshop and two eDelphi (Version 1, Duncan E, Swinger K, University of Stirling, Stirling, UK) studies to agree guidance content; and (4) the development of the guidance table and explanatory notes.

Results
Results from the methodological systematic review and the audit of published meta-ethnographies revealed that more guidance was required around the reporting of all phases of meta-ethnography conduct and, in particular, the synthesis phases 4–6 (relating studies, translating studies into one another and synthesising translations). Following the guidance development process, the eMERGe reporting guidance was produced, comprising 19 items grouped into the seven phases of meta-ethnography.

Limitations
The finalised guidance has not yet been evaluated in practice; therefore, it is not possible at this stage to comment on its utility. However, we look forward to evaluating its uptake and usability in the future.

Conclusions
The eMERGe reporting guidance has been developed following a rigorous process in line with guideline development recommendations. The guidance is intended to improve the clarity and completeness of reporting of meta-ethnographies, and to facilitate use of the findings within the guidance to inform the design and delivery of services and interventions in health, social care and other fields. The eMERGe project developed a range of training materials to support use of the guidance, which is freely available at www.emergeproject.org (accessed 26 March 2018). Meta-ethnography is an evolving qualitative evidence synthesis methodology and future research should refine the guidance to accommodate future methodological developments. We will also investigate the impact of the eMERGe reporting guidance with a view to updating the guidance.

Study registration
This study is registered as PROSPERO CRD42015024709 for the stage 1 systematic review.

Funding
The National Institute for Health Research Health Services and Delivery Research programme.

Citation

Cunningham, M., France, E. F., Ring, N., Uny, I., Duncan, E. A., Roberts, R. J., …Noyes, J. (2019). Developing a reporting guideline to improve meta-ethnography in health research: the eMERGe mixed-methods study. Health Services and Delivery Research, 7(4), 1-116. https://doi.org/10.3310/hsdr07040

• Journal Article Type: Article
• Acceptance Date: Oct 1, 2017
• Publication Date: 2019-02
• Deposit Date: Feb 28, 2019
• Publicly Available Date: Feb 28, 2019
• Journal: Health Services and Delivery Research
• Print ISSN: 2050-4349
• Electronic ISSN: 2050-4357
• Publisher: NIHR Journals Library
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 4
• Pages: 1-116
• DOI: https://doi.org/10.3310/hsdr07040
• Keywords: Meta-ethnography, qualitative evidence synthesis, health research.
• Public URL: http://researchrepository.napier.ac.uk/Output/1625295