Presentation realised for an organised session on Application and challenges to the use of mixed methods in health systems research, held at HSR 2016, the Fourth Global Symposium on Health Systems Research, Vancouver, 14-18 november 2016. Authors: Quan Nha Hong

1. Main types of designs and strategies for
synthesizing qualitative and
quantitative evidence in systematic
reviews
HSR 2016
November 16, 2016
Quan Nha Hong, OT, MSc, PhD(c)

2. Systematic Reviews of Qualitative and
Quantitative Evidence
 Growing in popularity
 Based on the literature on mixed methods research
– Mixed methods applied to literature reviews
 Different terms
– Integrative review
– Mixed methods research synthesis
– Mixed studies reviews
(Pluye & Hong, 2014; Heyvaert et al, 2016)

3. Types of systematic reviews
Quantitative
(QT) studies
Qualitative
(QL) studies
Mixed methods
studies
Quantitative
Review
Qualitative
review
Mixed studies
review
(Synthesis of QL and
QT evidence)

4. Steps of systematic review
Challenge #1
Challenge #2
Challenge #3
Challenge #4
Stage 1:
Formulate a review question
Stage 2:
Define eligibility criteria
Stage 3:
Sources of information
Stage 4:
Identify potential relevant studies
Stage 5:
Select relevant studies
Stage 6:
Appraise the quality of studies
Stage 7:
Extract data of included studies
Stage 8:
Synthetize included studies

5. 1. Data‐based CSD 2. Result‐based CSD 3. Parallel‐results CSD
II. Sequential synthesis design
I. Convergent synthesis design (CSD)
Synthesis designs

6. Data‐based convergent synthesis design
 One review question
– E.g.: What are the barriers and
facilitators of …?
 All extracted data analysed using a
same synthesis method
– Integration during the synthesis
QT
data
QL
data
QL or
QT
synth
Results
Discussion

7. Results‐based convergent synthesis
design
 Several questions:
– QT question: What is the impact of
intervention X on population Y…?
– QL question: What are the needs of
population Y …?
– Integration question: Does
intervention X address the needs of
population Y?
 QL and QT extracted data analysed
and presented separately
 3rd synthesis integrating all results
– E.g. side‐by‐side comparison
QT
data
QL
data
Synth
Results
QL or
QT
synth
QL or
QT
synth
Discussion
ResultsResults

8. Parallel‐results convergent synthesis design
 Different review questions:
– QT questions: effectiveness, cost‐
effectiveness or prevalence?
– QL questions: acceptability,
views, or needs?
 QL and QT data are analysed
and presented separately
 Integration in the discussion
QT
data
QL
data
QL or
QT
synth
QL or
QT
synth
Discussion
ResultsResults

9. Sequential synthesis design
 One or several reviews questions
– What are the factors…?
– What is the prevalence of these factors…?
 Synthesis results of phase 1 inform the synthesis of phase 2
 Integration between the 2 phases
QL/QT
data
QL/QT
data
Results
QL or
QT
synth
QL or
QT
synth
Results Discussion
Phase 1 Phase 2

10. quan.nha.hong@mail.mcgill.ca
http://mixedmethodsappraisaltoolpublic.pbworks.com
http://toolkit4mixedstudiesreviews.pbworks.com

11. References
 Heyvaert M, Hannes K, Onghena P. (2016). Using Mixed
Methods Research Synthesis for Literature Reviews: The Mixed
Methods Research Synthesis Approach (Vol. 4). Thousand
Oaks, CA: SAGE Publications.
 Pluye, P., & Hong, Q. N. (2014). Combining the power of stories
and the power of numbers: Mixed methods research and
mixed studies reviews. Annual Review of Public Health, 35, 29‐
45.