Challenges with integrating quantitative and qualitative evidence through mixed methods systematic reviews

Article type
Authors
Stern C1, Lizarondo L1, Rieger K2, Godfrey C3, Apostolo J4, Carrier J5, Borges Dos Santos K6, Kirkpatrick P7, Loveday H8
1Joanna Briggs Institute (JBI), University of Adelaide
2University of Manitoba
3Queens University
4Escola Superior de Enfermagem de Coimbra
5Cardiff University
6Universidade de São Paulo
7Robery Gordon University
8University of West London
Abstract
Background: Mixed methods systematic reviews (MMSR) represent an important development for those involved in evidence synthesis by combining quantitative and qualitative evidence to inform policy and practice. Although MMSR are becoming increasingly popular, there is a degree of complexity and guidance regarding the methodology of combining quantitative and qualitative data is limited.

Objectives: To provide an account of the challenges associated with integrating quantitative and qualitative evidence following the JBI methodology for conducting MMSR.

Methods: Two systematic reviews – one following the JBI convergent integrated approach to synthesis and integration and the other following the convergent segregated approach were conducted. A descriptive account of the main issues that were encountered by the authors during the data synthesis and integration stages of the reviews are presented as are recommendations regarding future enhancements to the methodological guidance.

Results: While undertaking synthesis and integration of both reviews a number of challenges arose. Using the integrated approach, issues relating to data transformation (including the qualitization of quantitative data) and integration (including assembling and pooling the data) emerged. In the review following the segregated approach, issues around the available evidence and heterogeneity of included studies impacted on the ability of the two types of research being able to ‘speak to each other’ whilst keeping their epistemological foundations. This resulted in limitations to the configured analysis of the qualitative and quantitative evidence.

Conclusions: MMSR provide an innovative approach for addressing important questions in health care as they allow for a richer understanding of a topic/phenomena however, the methods for synthesis and integration in MMSR are complex. Further methodological work is required to shed light to this emerging but rapidly evolving methodology.

Patient or healthcare consumer involvement: Nil involvement associated with the development of this protocol