HTAi15 IRG Advanced Searching Workshop: Qualitative Evidence

IRG BoothWhen I found out that Andrew Booth from ScHARR was going to be presenting at the IRG Advanced Searching Workshop, that was a decision maker for me. My education plan includes teaching methods for finding qualitative research and since I know Booth is an excellent teacher, I though it a brilliant opportunity.Β  I also know from previous experience that Booth loves acronyms so I had to laugh when I saw the opening slide of his presentation (above). Systematic reviews of qualitative research is increasing, and according to Booth, there are around 12 a month hitting the databases (the search strategy used to determine this interested me: Topic=(“qualitative systematic review” OR “qualitative evidence synthesis” OR “qualitative research synthesis”) OR Topic=(metastudy OR metasynthesis OR “meta synthesis” OR “meta ethnography” OR “meta ethnographic” OR “metaethnography” OR “metaethnographic”) OR Topic=(“systematic review of qualitative”). The main difference between quantitative and qualitative SRs is that while the former seeks to pool numerical results, the latter seeks to find themes or constructs – it is an interpretive exercise which aims to gather insights. Qualitative SRs answer questions such as how and why interventions work or don’t work, what outcomes matter to patients, and what patient experiences of disease are to name a few. The hardest thing about qualitative evidence is appraisal, so I was glad to find out about a method which Booth says is similar to GRADE. CERQual‘s aims to assess how much confidence can be had in the evidence in qualitative reviews. There are four components to this: methodological limitations of the included studies; coherence of the review; relevance of the studies to the research question; and adequacy of the data. Creating a search strategy can use these components as a guide: use methodological filters to find high quality studies; use sampling to retrieve papers that provide a fair representation of the phenomenon; use question mnemonics to guide search strategy formation; and use alternate search strategies to locate similar studies. There are a few question mnemonics to choose from: SPICE, ProPheT, ECLIPSE, SPIDER. It was fun to test these tools with a qualitative research question – one of the really useful workshop activities. Now onto something tricky – searching! The next activity was assessing whether an article was qualitative research or not and if not, why it came up in the retrieval set. I really liked this activity and will copy it in my own sessions – it is one where you can learn a lot from. And of course, there was another acronym to help with identifying qualitative research! ESCAPADE asks what methods, approaches and data were used. Now for qualitative filters. Filters are search strategies that identify papers using specific study designs or publication types and subject terms/free text terms used in high quality studies. Some of them are one liners: MeSH Qualitative Research (though it has some limitations as this subject added in 2003). Many of these filters are available via the ISSG Filter Resource. Booth mentioned the health services research filter available through the PubMed Topic Specific Queries (which I have to say I haven’t looked at often) which includes a qualitative research option. The third activity was an interesting and useful exercise too and one worth reusing: what weakness can you spot in a filter and what is one instance in which a filter could be useful? Next up was the sampling search method. I have a hard time with this because one of the mantras with searching for SRs is comprehensiveness. But this is impossible to achieve in reality for many reasons. SRs address specific questions and have strict inclusion and exclusion criteria and so there are set boundaries – the key is to be exhaustive within these. In qualitative research, the boundaries are more fluid. Is sampling the answer and what is it anyway? Sampling is used to reach data saturation (until information repeats itself and nothing new is gleaned). So instead of having more of the same information, only retain information that explains a concept, confirms interconnections or assists in argument formation. Where can studies be found? Don’t rely on databases – use expansive searches to include footnotes (risk of confirmation bias), citation tracking and snowballing, theses and books and other grey literature. A concept that Booth mentioned was sibling studies – different studies in the same context Sampling - cluster searches(I might not have got this right). Clustering is a search strategy technique used for identifying sibling studies. This is a difficult concept for me even though I use some of the techniques in isolation. I guess it is a matter of being a little more systematic (!) in my approach. Phew – it was an intense session which could have gone on all day. Well worth attending – and I encourage you to attend any sessions run by Andrew Booth – they are really good.

And did I do the acronym challenge? I did but stopped 1/2 through the session because there were so many and I was loosing track!

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