Brunton, Virginia; (2017) Innovation in systematic review methods: successive developments in framework synthesis. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Background: Systematic reviews are used increasingly to synthesise research for policy and practice decisions. Systematic reviews use transparent, explicit and consistent methods to identify, appraise and integrate research evidence, to inform existing assumptions. Traditionally used to examine the effects of health care, systematic review methods have evolved to address more complex issues across health and social policy. Framework synthesis is one systematic review method employed to address such complexity. Adapted from framework analysis used in primary research, framework synthesis begins with an a priori conceptual framework, which develops iteratively as new data are incorporated and themes derived from the data. Framework synthesis has been used increasingly in qualitative and mixed-method systematic reviews, sometimes incorporating stakeholder consultation to describe and interpret review findings. Aims: This thesis will demonstrate how my development of framework synthesis methods is situated within, and contributes to, wider debates about research synthesis methods in systematic reviews. Methods: I conducted an overview of systematic reviews. A systematic review of the literature discussing or employing framework synthesis methods was conducted. Included studies were ordered and synthesised using framework synthesis methods. The resulting conceptual framework structured the assessment of each of the submitted publications (the ‘thesis reviews’). Findings were subsequently incorporated into the conceptual framework and higher order themes derived using constant comparative analysis. Results: This thesis distinguishes two key approaches to framework synthesis: one approach that constructs a framework (often in discussion with stakeholders) to accommodate research from across academic disciplines and/or policy sectors; and the ‘best-fit’ approach that borrows a framework from a related area to initiate synthesis within a narrower disciplinary or policy scope. Its utility is demonstrated in handling mixed methods and mixed sources reviews, using diverse data types and synthesis methods in order to generate, explore and/or test theory in collaboration with stakeholders. I conclude that framework synthesis is a very flexible research synthesis method that can meet the complex conditions and epistemology arising from public health policy issues.

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