Combining adjusted and unadjusted findings in mixed research synthesis

CI Voils, JL Crandell, YK Chang… - Journal of evaluation …, 2011 - Wiley Online Library
CI Voils, JL Crandell, YK Chang, J Leeman, M Sandelowski
Journal of evaluation in clinical practice, 2011Wiley Online Library
Rationale, aims and objectives Finding ways to incorporate disparate types of evidence into
research syntheses has the potential to build a better evidence base for clinical practice and
policy. Yet conducting such mixed research synthesis studies is challenging. Researchers
have to determine whether and how to use adjusted and unadjusted quantitative findings in
combination with each other and with qualitative findings. Methods Among quantitative
findings, adjustment for confounding, either via study design or statistical analysis, can be a …
Abstract
Rationale, aims and objectives  Finding ways to incorporate disparate types of evidence into research syntheses has the potential to build a better evidence base for clinical practice and policy. Yet conducting such mixed research synthesis studies is challenging. Researchers have to determine whether and how to use adjusted and unadjusted quantitative findings in combination with each other and with qualitative findings.
Methods  Among quantitative findings, adjustment for confounding, either via study design or statistical analysis, can be a considerable source of heterogeneity. Yet there is no consensus about the best way to synthesize findings resulting from different methods for addressing confounding. When synthesizing qualitative and quantitative findings, additional considerations include determining whether findings are amenable to synthesis by aggregation or configuration, which, in turn, depends on the degree of interpretive transformation of findings.
Results  Qualitative survey findings appear similar in form to unadjusted or minimally adjusted quantitative findings and, when addressing the same relationship, can be summed. More interpreted qualitative findings appear similar in form to adjusted findings found in, for example, structural equation models specifying the relationship among a host of latent variables. An option for synthesis of conceptually similar models is reciprocal translation.
Conclusions  These decisions will ultimately be judged on the meaningfulness of their results to practice or policy.
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