Systematic review and synthesis of quantitative and qualitative research: A worked example to assess community preferences

Article type
Authors
Tong A1, Howard K1, Jan S2, Cass A2, Rose J1, Chadban S1, Allen R1, Craig J1
1University of Sydney, Australia
2The George Institute for Global Health, Australia
Abstract
Background: The synthesis of qualitative research and mixed method synthesis are important and emerging methodologies in health research. It is increasingly recognised as a useful approach for understanding consumer and community preferences for health services and policy.

Objectives: To describe our methodology for appraising and analysing the findings of qualitative and quantitative studies on community preferences for the allocation of solid organs for transplantation, and to describe the utility of this approach.

Methods: For the quantitative survey studies, we appraised study reporting according to a comprehensive list of criteria we developed based on items reported in the included studies and additional items in published guides for designing survey studies. We synthesised the survey results by extracting items assessed by the survey and the respective participant responses. For the qualitative studies, we used the consolidated criteria for reporting qualitative studies (COREQ) framework which included criteria specific to the research team, study methods, context of the study, analysis and interpretations. We performed a textual synthesis of the results and conclusions reported by the primary author of each study.

Results: Fifteen studies were included (n = 5563 respondents). We identified 15 attributes relating to community preferences for organ allocation and identified consistencies across survey studies in community preferences for prioritising for 'younger age’, 'time on waiting list’, and 'better prognosis' after transplant. Seven main themes underlying their preferences were identified from the textual synthesis: maximum benefit, social valuation, moral deservingness, prejudice, fair innings, first come, first served, and medical urgency.

Conclusions: Using this approach, we found that community preferences for organ allocation hinge on a complex balance of efficiency, social valuation, morality, fairness, and equity principles. Pairing qualitative and quantitative studies within a review can generate more complete data, corroborate findings across studies, and enhance or explain insights attained with the complementary method.