Yes, qualitative systematic reviews synthesize insights from qualitative studies with transparent, reproducible methods.
Many researchers meet the term “systematic review” and think meta-analysis of trials. That’s only one branch. A large and growing body of work uses protocol-driven methods to bring together interviews, focus groups, observations, and open-ended survey data. These projects ask how and why things happen, map experiences, and build explanations from people’s words and actions. The end product isn’t a pooled effect size; it’s a reasoned picture of themes, mechanisms, and contexts that help decision makers act with confidence.
What A Qualitative Systematic Review Really Does
The aim is to locate relevant qualitative studies, appraise them, extract findings, and combine those findings through an explicit synthesis approach. That approach looks different from statistics, but the backbone is the same: prespecified criteria, comprehensive search, dual screening where possible, documented decisions, and a clear audit trail. Instead of risk ratios or mean differences, you’ll see themes, concepts, and mid-level theories built through interpretation.
| Approach | What It Synthesizes | Common Outputs |
|---|---|---|
| Qualitative evidence synthesis | Interviews, focus groups, observations, textual data | Themes, conceptual models, context-mechanism links |
| Quantitative review | Trials, cohort studies, numerical outcomes | Effect estimates, meta-analysis, certainty of effect |
| Mixed-methods review | Both qualitative and quantitative bodies | Integrated model that explains outcomes and experiences |
Two major playbooks guide this work. The Cochrane chapter on qualitative evidence explains how to plan, search, appraise, and integrate non-numerical findings, including ways to link to decision making in guidelines and policy. JBI’s manual sets out meta-aggregation and related methods used widely across health and social care. These frameworks keep the process disciplined, so readers can see exactly how interpretations were built from the included studies.
Are Qualitative Evidence Syntheses Considered Systematic Reviews?
Yes. These reviews use the same backbone that defines a review as systematic: a protocol, explicit eligibility criteria, an exhaustive or purposefully comprehensive search, critical appraisal, and a prespecified synthesis plan. The difference is the nature of the data and the logic of combination. Where meta-analysis aggregates like-with-like numbers, qualitative synthesis translates concepts across studies and tests how well emerging explanations fit the full set of evidence.
When To Choose A Qualitative Evidence Synthesis
Pick this route when your question centers on lived experience, barriers and enablers, acceptability, feasibility, or implementation. It’s the right tool when you need to understand why an intervention works in some settings and not others, what matters to participants, or which contextual features shape outcomes. Policymakers often pair a qualitative synthesis with an effectiveness review so guidance reflects both outcomes and real-world perspectives.
Close Variant In Plain Terms: Are Qualitative Evidence Syntheses Systematic, And When Should You Use Them?
In practice, a qualitative synthesis is every bit as systematic as a numbers-based review. You still pre-register, you still document the search, and you still judge study quality. You just work with words and meanings instead of measurements. Use it when you’re aiming to explain processes, values, expectations, and lived barriers that shape whether an intervention sticks.
Methods You’ll See, And What They Deliver
There isn’t one single synthesis method. Teams select an approach that matches their question and the character of included studies. Below are common choices and what they tend to produce.
Thematic Synthesis
This approach codes findings line-by-line, groups them into descriptive themes, and then builds analytic themes that answer the review question. It works well when included studies share a practical topic and you need clear takeaways that can inform service design, education, or implementation.
Meta-Ethnography
Meta-ethnography treats each study’s interpretations as data, translates concepts across studies, and generates a “line-of-argument” model. It shines when the aim is to develop a higher-order explanation from interpretive research, such as how people make sense of risk, stigma, or change across settings.
Framework Synthesis
Here, reviewers map data into an a priori framework (such as a behavior change or implementation model) and then refine that framework based on the evidence. It’s efficient for policy timelines or topics with an existing taxonomy that stakeholders already use.
Meta-Aggregation
Popular in JBI guidance, meta-aggregation groups findings, rates their credibility, and produces synthesized statements that can inform recommendations without stretching beyond what the data support.
| Method | Best For | Hallmarks |
|---|---|---|
| Thematic synthesis | Clear practice questions | Coding to themes; stepwise build to analytic statements |
| Meta-ethnography | Conceptual theory building | Translation of concepts; line-of-argument model |
| Meta-aggregation | Decision-ready summaries | Credibility ratings; synthesized findings phrased as statements |
| Framework synthesis | Policy timelines | Uses predefined framework; rapid mapping and refinement |
Core Steps, From Question To Synthesis
1) Frame A Focused Question
State the phenomenon of interest, participants, setting, and outcome type (such as experiences, barriers, or values). Replace PICO with purpose-built variants like SPIDER or PICo if that suits your topic. Keep the scope tight enough to synthesize meaningfully, yet wide enough to capture diverse contexts.
2) Register Or Publish A Protocol
Declare your plan up front: databases to search, eligibility rules, appraisal tools, and the synthesis method. A registered protocol signals predictability and reduces bias drift during screening and analysis.
3) Search Broadly And Purposefully
Use subject databases and grey sources. Pair controlled vocabulary with natural-language terms for designs, settings, and participant groups. Include forward and backward citation chasing, hand-searching key journals, and contacts with topic experts. Document the full strategy, including dates and any filters used.
4) Screen In Duplicate Where Feasible
Run a pilot to refine your rules, then apply them consistently. Keep a log of reasons for exclusion at the full-text stage. Report counts with a flow diagram so readers can follow each decision.
5) Appraise Methodological Quality
Choose a fit-for-purpose tool (such as CASP Qualitative or the JBI checklist) and rate each study. Report the process and how the appraisal influenced inclusion, weighting, or sensitivity checks. Avoid blanket scoring that hides nuance; describe what the judgments mean for confidence in the evidence.
6) Extract Findings, Not Just Quotations
Pull out each study’s stated findings alongside supporting data, context, and author interpretations. Note study aims, setting, sample, and analytic approach so you can judge transferability later. Quotations help illustrate meaning, but the interpretation is the unit you combine.
7) Synthesize With An Explicit Method
Apply your chosen method consistently. Keep an audit trail: coding frames, concept maps, memos, and decision points. Test early themes against disconfirming cases before you settle on final interpretations. If you adapt methods, state what changed and why.
8) Assess Confidence In The Synthesized Output
Use a structured approach such as GRADE-CERQual to judge confidence in each key finding across four domains: methodological limitations, coherence, adequacy, and relevance. Present confidence alongside each finding so readers can gauge strength at a glance.
Reporting So Readers Can Trust The Results
Transparent reporting matters. A PRISMA-style flow diagram, a detailed search appendix, a table of included studies, a clear description of appraisal, and a step-by-step account of the synthesis help others follow your path. Pair that with plain-language key findings that state what the evidence suggests and where confidence is strong or weak. When you share data extraction templates or coding frames, readers can see how interpretations were formed.
How Qualitative And Quantitative Evidence Work Together
Many guideline panels blend an effects review with a qualitative synthesis. The effects review answers what works and how much. The companion explains acceptability, feasibility, equity issues, and likely implementation barriers. Put together, the package helps craft recommendations that are both evidence-based and workable in real settings. This pairing is common in complex service change, public health, and education.
Avoid Common Pitfalls
Vague Questions And Over-Broad Scope
Without a crisp focus, the search balloons and the synthesis blurs. Define the phenomenon and settings early, and be ready to split one giant idea into several targeted reviews. A short scoping exercise can help calibrate breadth before you lock the protocol.
Only Collecting Quotations
Lifted quotes can be vivid, but the unit of analysis is the study’s finding. Always pair quotations with the authors’ interpretations and context so your synthesis builds on meaning, not fragments. When coding, keep a separate channel for authors’ takeaways alongside participant voice.
Blending Methods Haphazardly
Don’t mix thematic coding with meta-ethnography mid-stream unless your protocol allowed an adapted approach. Pick a lane that suits the material and stick to it. If you run a hybrid, describe the junctions clearly and justify each step.
Rushing The Search Or Appraisal
Lean searches miss perspectives. Skipped appraisal weakens confidence judgments. Budget time for both, and show your working with appendices and supplementary files. Where time is tight, a framework-based approach can keep the process orderly without cutting corners.
Practical Outputs Stakeholders Value
Well-run syntheses deliver concise lists of findings with confidence ratings, an evidence-to-decision table, and a conceptual model that shows how context and mechanism interact. These products help program leads, clinicians, educators, and funders anticipate barriers, tailor strategies, and communicate with clarity. Brief plain-language summaries can help non-technical audiences engage with the results.
Where To Learn The Craft
Two resources stand out for hands-on guidance. The Cochrane chapter on qualitative evidence offers step-by-step instruction and links to training on planning, searching, appraisal, synthesis choices, and confidence assessment. JBI’s manual details meta-aggregation and provides templates, checklists, and worked examples used across many health systems. Start with those, then branch into method-specific texts on meta-ethnography and thematic synthesis as your questions demand.