The licorice allsorts approach: review and synthesis of a mixed bag of research

Article type
Authors
Hill S
Abstract
Introduction: Randomised trials are seen as the gold standard in a panoply of research methods. However, much of the research which concerns itself with problems as defined by consumers of care - patients, carers, members of the public - is usually a very mixed bag in terms of methods used. What are the issues in a review and synthesis (or meta-analysis) of a mixed bag? How can we consume (and enjoy the benefits) of the liquorice allsorts, in addition to the gilded sweeties?

Objective: This paper will highlight some issues for discussion in the systematic review of research by many methods, ie, a range of quantitative and qualitative methods.

Methods: Three reviews were conducted. Each involved a review and synthesis of research about consumers' concerns with, and experiences of care. The research included case studies, focus groups, interviews and questionnaires (all types), literature reviews and trials. There was a deliberate strategy to seek out research by all parties: consumer/community groups, academics (medical and social), and hospital and government departments.

Results: Each review was an input to a policy development process. The synthesis of issues for consumers was used alongside other data reviews in formulating policies to improve care.

Discussion: There are several critical issues. Research results are complementary, not additive. Some types of research give us only glimpses - and murky at that if poorly done. But each work must be assessed according to the standards of each method, not according to a hierarchy. Different kinds of research give different insights, and so should not be discarded. In some fields, much of the experience of care is assumed to be unproblematic and so little if any research about people's concerns has been done. These gaps are made clear by this kind of review.